Distributed to some depository libraries in microfiche.

Assesses the extent of the drug diversion problem, the reason it persists, & what actions are being taken to bring it under control. Compares the incidence & outcomes of malpractice litigation involving Medicare & Medicaid patients to that of the general population & analyzes aggregate hospital data on malpractice losses for Medicare, Medicaid, & other hospital patients. Assesses the methods being used to approve or deny Medicare Part B claims. Describes the characteristics of claims denials that are appealed & of those that are reversed. Illustrated.

A pill millÓ operates when physicians, clinic owners, & pharmacists collect to defraud Medicaid by prescribing & distributing drugs mainly to obtain reimbursement. Patients are often knowing participants in these schemes, allowing use of their Medicaid recipient numbers for billing purposes in exchange for cash, drugs, or other inducements. This report assesses the extent of the drug diversion problem, the reasons it persists, & what actions are being taken to bring it under control. Charts & tables.

Distributed to some depository libraries in microfiche.