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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
Department of Health & Human Services
High Part D Spending on Opioids and Substantial Growth in Compounding Drugs Raise Concerns
Since the Part D program went into effect in 2006, the Office of Inspector General (OIG) has had ongoing concerns about abuse and diversion of Part D drugs. In June 2015, OIG released a data brief, Questionable Billing and Geographic Hotspots Point to Potential Fraud and Abuse in Medicare Part D, which described trends in Part D spending and identified questionable billing by pharmacies. This data brief builds on that body of work. It updates information on spending for commonly abused opioids and provides data on the dramatic growth in spending for compounded drugs.
During a prior review of a Medicaid-funded mental health program in New York State (the State), we observed that some providers were paid more than the Medicaid base rate for certain services. These providers participated in the State's Comprehensive Outpatient Program Services (COPS) and Community Support Program (CSP) programs and, as program participants, received supplemental (add-on) payments subject to annual payment thresholds in exchange for offering "enhanced services" to Medicaid beneficiaries. We decided to review these add-on payments and other aspects of the State's COPS and CSP programs.
Termination Memorandum – Office of the Comptroller of the Currency’s Bank Secrecy Act /Anti-Money Laundering Compliance Examinations and Enforcement Actions
