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Diane Publishing Books
Medicare Part D: Some Plan Sponsors Have Not Completely Implemented Fraud and Abuse Programs, and CMS Oversight Has Been Limited
Kathleen M. King (au)
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit, known as Medicare Part D. The Centers for Medicare and Medicaid Services (CMS) contracts with private companies to serve as Part D sponsors and administer the Part D prescription drug benefit plans. The MMA requires Part D sponsors to implement programs to control for fraud and abuse. This report examines: (1) the extent to which certain Part D sponsors have implemented programs to control fraud, waste, and abuse; and (2) the extent of CMS’s oversight of Part D sponsors’ programs to control fraud, waste, and abuse. Includes recommendations. Charts and tables.
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