Review of Medicare Part D Prescription Drug Event Data for Schedule II Drugs at United HealthCare Medicare and Retirement.

摘要

United HealthCare Medicare & Retirement (United) contracted with CMS as a Part D sponsor to provide prescription drug benefits to eligible Part D beneficiaries. United provided prescription drug coverage to approximately 1 million beneficiaries and submitted to CMS over 9.7 million PDE records for Schedule II drugs for dates of service from January 1, 2008, through June 30, 2010. Our objective was to determine whether United had adequate controls to (1) prevent refills and unallowable partial fills of Schedule II drugs and (2) ensure the accuracy of certain fields in the PDE records submitted for Schedule II drugs.