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A recent state audit found that Medicaid money was used to pay for a small number of prescriptions written by dead doctors.
This is just one of many problems in Utah's Medicaid prescription drug controls unearthed by the state Auditor's Office in a report released this week.
"Insufficient or lacking controls may have allowed improper Medicaid payment for controlled-substance prescriptions written and dispensed by ineligible providers," an office news release states. "Failure to properly control prescription drug utilization may result in fraud, waste, and abuse of Medicaid services and unnecessary public safety risks."
The audit comes as Utah continually finds itself among the top states for prescription drug poisoning deaths: Utah ranked fourth in the country between 2012 and 2014, according to the state Department of Health's website. The department oversees the state's Medicaid program.
Put another way, 24 Utahns die every month from prescription drug overdoses a rate that outpaces motorcycle and firearms deaths, according to the department.
The recent audit examined pharmacy claims data between July 2014 and March 2016, which included millions of pharmacy claims.
Auditors found that the state paid claims for 59 prescriptions written by 11 prescribers after their death.
Department officials were able to reverse a number of the claims in question, according to their response to the audit.
Prescriptions also were being dispensed to dead recipients during that time.
More than 50 prescriptions for 25 people were dispensed after those people died. In some cases, those prescriptions appeared to be written after his or her death.
A letter to the auditor from department officials states that death records are uploaded weekly to the Medicaid data warehouse. This information is used to reverse claims from dead recipients and close contracts with dead prescribers, but the letter states that some slipped through the cracks because "our process did not include reversing claims processed by" a certain contracted vendor.
Department officials also were able to reverse a number of these claims as well.
Recommendations from the auditor's office include proactively avoiding paying prescription claims written after the death of the prescriber and investigating every prescription from a prescriber who died before the prescription was written.
Auditors also recommend the department avoid paying prescription claims written or dispensed after a recipient has died and that officials identify people who are involved in the "potentially fraudulent or abusive conduct."
The audit also found evidence that claims were being paid for prescriptions written by doctors who could not prescribe to Medicaid recipients 234 prescriptions, to be exact.
"We concur with the recommendations in this report and will use the recommendations to strengthen the policies, procedures and internal controls of the program," said Nate Checketts, the department's deputy director.
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