Mid-Atlantic Health Law TOPICS

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Fraud-Busting 'MEDICs'

In the past, if you heard the word MEDIC, you likely thought of Radar O'Reilly or Klinger from M*A*S*H. However, if you see the word MEDIC in 2006, it likely means a "Medicare Rx Integrity Contractor" who is investigating fraud, waste, or abuse in regard to the new Medicare Part D prescription drug plan.
On October 7, 2005, the Centers for Medicare and Medicaid Services (CMS) announced that eight contractors would be granted contracts to investigate fraud, waste and abuse regarding Medicare Part D. The contractors include the Delmarva Foundation for Medical Care, Inc. and its wholly owned subsidiary Health Integrity, LLC, both of Easton, Maryland.
CMS hopes that MEDICs will curtail fraud from: phantom buyers of Medicare prescription drug cards; identity theft associated with Medicare and Social Security numbers; age, health, race, religion, or income discrimination by prescription drug plans; illegal cash incentives for enrollment in a Medicare prescription drug plan; and overbilling to Medicare or beneficiaries for prescription drugs.


March 20, 2006




Rosen, Barry F.


Health Care