Partner Ericka Adler shared her observations on recent HHS and CMS actions in regard to Medicare Part D enforcement in Modern Healthcare.
From the article:
"Ericka Adler, a healthcare partner at law firm Roetzel & Andress in Chicago, also said Tuesday she's not surprised that the CMS hasn't yet fully implemented all of the OIG's recommendations given the size of the Medicare Part D program.
Adler called the OIG's reports a step in the right direction but also cautioned that, in some cases, providers who might seem to be prescribing suspicious amounts of opioids or other drugs might have legitimate reasons for doing so. They might, for example, specialize in treating patients in a lot of pain. Some geographic areas might also pop up as “hot spots” for certain medications because doctors in those areas might be communicating with each other about their successes with certain types of drugs, she said.
'It paints a picture that's not the clearest picture,' Adler said of the reports' focus on potential areas of fraud, 'Just reading it, I think it's alarming, but if you get a little more information it might be less alarming.'"
Excerpted from "Congressmen press HHS to investigate Universal Health Services' behavioral facilities." (Subscription may be required)