Oversight is not the chance reporting by a single guy that there seems to be something funny going on, except for CVS, the feds and all states involved, yeah it is.
CVS is paying $37 million to governments for Medicaid fraud. The interest in this news story is that first CVS will pay $21 million to the federal government and the remaining approximately $16 million to state Medicaid programs.
The second point of interest is how the case came to be. Was it the oversight of governments? Was it any government employee? Was it technology flagging the fact that a generic antacid was being substituted with a more costly generic antacid amounting to excessive costs? Who was watching the store as capsules of Ranitidine which allegedly cost the government four times as much as a cheaper alternative was dispensed time and time and time again. Who has lost their jobs for the action?
For the second question, there is no information. Of course not, the decision itself reflects CVS's conviction that the decision reflects no wrongdoing on its part...no wrongdoing, nobody is fired, which works out well because there is no parade of names of people who should be held responsible. Regarding how the fraud was discovered, reported and acted upon?
Reports note that the case started with the report in 2001 when "a suburban Chicago pharmacist alerted authorities." With all the federal employees, state employees, pharmacy employees involved, the official evidence that the system "works" depends on the report of a single suburban pharmacist?
This idiocy highlights two things: Too many federal and state paper pushers and not enough auditors. It's time for boots on the ground oversight and enough of the behind the desk, anonymous, blundering bureaucrat. People should lose their jobs within each government's anti-fraud department, but they won't. Paper pushing jobs do not require endless bodies, get rid of them and give them the chance to go out and do real legwork and verify what's going on.
