
Herceptin, which is used to treat breast cancer that has spread to other parts of the body, normally is supplied in multiuse 440-milligram vials that can be stored for up to 28 days.
But the HHS inspector general, the department's internal watchdog, found that Medicare providers were billing the government for the price of a full vial, even for portions for a single patient.
"Because Herceptin is supplied in a multiuse vial, providers should bill Medicare only for the actual dose of Herceptin administered to the patient. Providers should not bill Medicare for a full vial of Herceptin unless the patient actually received a full vial of the drug," said Leslie Preuss, a senior inspector general auditor who helped lead the investigation. "These improper billing practices cost the Medicare program millions of dollars and may have subjected cancer patients to higher co-pays."
Investigators suspect the government overpaid on 77 percent of the drug purchases because the oversight process wasn't good enough to catch the mistakes.
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