Drug benefit at risk for fraud and abuse, assistant U.S. attorney says

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The Medicare prescription drug benefit is prone to fraud and abuse, according to an assistant U.S. attorney.

The benefit will involve $60 billion in new federal money each year, increasing the risk of fraud and abuse in the benefit, said James G. Sheehan, assistant U.S. attorney for the Eastern District of Pennsylvania. Potential fraud concerns include counterfeit, diluted or purposely mismarked drugs.

Sheehan also expects a rise in federal false claims violations. Pharmaceutical fraud involving any major prescription drug plan is now a fraud against the Untied States. Such violations could rise because pharmaceuticals involve the largest number of claims in the health system, and the over-65 population is the heaviest per capita users of prescription drugs.