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    Medicare Fraud, Waste & Abuse

    The Academy has taken a leading role in the effort to combat fraud, waste and abuse in the Medicare system. The Academy is collaborating with the CMS Outreach and Education MEDIC (Medicare Integrity Contractor) to combat fraud, waste and abuse in Medicare Parts C and D. The collaborative effort stems from AMCP’s work with Congress and the Obama Administration to introduce legislation that would suspend payment of claims to pharmacies where there is a credible allegation of fraud.

    The CMS O&E MEDIC is responsible for sharing information and creating tools that enable anti-fraud professionals to work smarter on fraud in Medicare Parts C and D.

    Summary of AMCP's Anti-fraud Bill: Medicare Prescription Drug Anti-Fraud Act of 2015
    This document is a summary of AMCP's anti-fraud Bill drafted September 2015.

    AMCP's House Anti-Fraud Bill: Medicare Prescription Drug Anti-Fraud Act of 2015
    This Bill is drafted to amend title XVIII of the Social Security Act to permit prescription drug plan sponsors to withhold payments to pharmacies based on credible allegations of fraud, and for other purposes.

    AMCP's Senate Anti-Fraud Bill: Medicare Prescription Drug Anti-Fraud Act of 2015
    This Bill is drafted to amend title XVIII of the Social Security Act to permit prescription drug plan sponsors to withhold payments to pharmacies based on credible allegations of fraud, and for other purposes.

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