Fraud Kicks in Months Ahead of Medicare Drug Discount Card

[Guest guest]

Fraud Kicks in Months Ahead of Medicare Drug Discount Card

WASHINGTON, Federal officials said Monday that

they had detected evidence of fraud in the marketing of

drug discount cards under the Medicare law signed 10 weeks

ago by President Bush.

In some parts of the country, people have gone door to door

offering " Medicare approved " cards, though none have been

approved and enrollment does not begin until May, federal

health officials said.

Mr. Bush has said that the cards, to be issued by private

entities and endorsed by the government, will deliver

" savings of 10 to 25 percent off the retail price of most

medicines, " though the amount will vary drug by drug and

card by card. In addition, as he noted in signing the

legislation on Dec. 8, low-income elderly people will be

eligible for " a $600 credit on their cards, to help them

pay for the medications they need. "

Beneficiaries can sign up for the cards in May and start

using them in June. But already, federal officials said,

some people are promoting the cards as if they had received

a federal seal of approval.

Valeria , an insurance specialist at the federal

Centers for Medicare and Medicaid Services, said, " Someone

is fraudulently impersonating or misrepresenting Medicare

by telephone and by door-to-door visits to beneficiaries'

homes, to discuss the Medicare discount drug program and to

obtain personal identifying information from

beneficiaries. "

In some cases, Ms. said, the caller seems to have

obtained personal information about beneficiaries before

visiting their homes.

Federal officials said the scheme was discovered by the

Atlanta regional office of the Medicare agency, which

covers eight Southern states. Medicare contractors in the

West and the Midwest said they were looking into reports of

similar activity.

Ms. said that a Medicare beneficiary in Georgia had

called the government and its local contractor wanting to

know if Medicare representatives were going door to door,

discussing the discount program.

" The answer should be no! " she wrote, and she added:

" Beneficiaries should not be giving anyone their personal

identifying information. Medicare has not begun its

enrollment, marketing or outreach process yet for our

beneficiaries regarding the prescription discount drug

program. "

The discount card will offer temporary assistance to the

elderly and disabled until Medicare provides a full-fledged

drug benefit in January 2006.

The deadline for companies to seek federal approval of

discount cards was Jan. 30. The Bush administration said it

had received 106 applications.

One possible complication is that the application form

required companies to disclose any past or pending

investigations or legal actions relating to their business

practices.

At least two applicants, Medco Health Solutions and Express

Scripts, are involved in such proceedings.

In a lawsuit filed by the United States attorney in

Philadelphia, the Justice Department contends that Medco

destroyed and fabricated records, billed clients for more

pills than it delivered and switched patients to

higher-cost medications in an effort to increase the

company's revenue.

Express Scripts manages drug benefits for New York State

employees. The company disclosed in June that it had

received a subpoena from the attorney general of New York,

Eliot Spitzer, seeking information about its compliance

with antitrust and consumer protection laws. In December,

two groups of state employees sued Express Scripts,

asserting that the company had retained millions of dollars

in discounts and rebates that should have been shared with

state workers.

Both companies have denied wrongdoing.

" We are a large company with net revenues of $34 billion a

year and 62 million beneficiaries, " said P. Driscoll,

senior vice president of Medco. " From time to time we're

involved in litigation, but we're confident in our ability

to fulfill the requirements for the drug discount card. "

The government will provide a Web site enabling

beneficiaries to compare prices.

Such detailed information has not been easily available in

the past and could be immensely useful to consumers. But

consumer groups and drug companies said it would not be

easy for the government or its contractors to compile the

prices, which could change week to week.

http://www.nytimes.com/2004/02/17/politics/17DRUG.html?ex=1078009573 & ei=1 & en

=0d301c0c482d2be5

------ End of Forwarded Message

------ End of Forwarded Message