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PCMA: Anti-Fraud Group Spotlights Policies that Promote Health Care Fraud and Abuse
Date:3/2/2011

WASHINGTON, March 2, 2011 /PRNewswire-USNewswire/ -- As the U.S. House of Representatives Ways and Means and House Energy and Commerce Committees and the U.S. Senate Finance Committee all hold hearings today on combating health care fraud, waste, and abuse, an analysis that examines the "Seven Guiding Principles for Policymakers" to fighting health care fraud invites new questions about legislative efforts to reduce accountability and oversight of independent drugstores, the Pharmaceutical Care Management Association (PCMA) said today.

"Unfortunately, some policies meant to help independent drugstores merely reduce accountability and promote fraud, abuse, and wasteful spending.  It's bad policy to make private payers partner with independent drugstores that are suspected of fraud, can't be effectively audited, or have been banned from federal programs," said PCMA President and CEO Mark Merritt. 

The white paper was published by the National Health Care Anti-Fraud Association (NHCAA),  the leading national organization focused exclusively on combating health care fraud.  The "Seven Guiding Principles for Policymakers" seek to address the estimated $70 to $234 billion in annual financial losses resulting from fraud throughout the health care system and warns policymakers to avoid policies that could undermine fraud fighting efforts. 

Specific questions should be raised about the following legislative proposals promoted by the independent pharmacy lobby:

  • Policies that undermine authority across Medicare to suspend payments when there is suspicion of fraud.  The ability to stop fraud before paying a claim is more effective and more efficient than relying on paying first and then chasing after claims that are later found to be fraudulent.  Congress should extend to Medicare Part D and indepen
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SOURCE Pharmaceutical Care Management Association
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