Houston Social Security
Disability Attorney

Photo of David Dopkin
Photo of David Dopkin

Should Medicare be monitoring doctor in network more closely?

On Behalf of | May 16, 2013 | Social Security Disability

Some people here in Texas may remember the case of the Webb family back in 2008. Shortly after placing their 79-year-old family member in a Fort Worth nursing home for rehabilitation on her back, the elderly woman was prescribed a lethal dosage of pain killers from which she later died. The family sued in 2008, at which point the doctor admitted to prescribing her the dosage despite being told to reduce it.

Now this Texas family, and others just like them, feel that Medicare should pay closer attention to doctors being paid by this system so as to avoid instances like this from happening again. And with the program serving more than 35 million elderly and disabled people at the moment, there is a strong likelihood that something such as this could happen again.

As if worrying about whether your disability benefits will be denied or not, beneficiaries who are on Medicare might have to be concerned about whether their healthcare provider really has their best interest in mind.  Because Medicare pays out million s every year for prescriptions written by physicians within the system, there is a growing concern that some doctors may doing it for profit rather than helping ailing people get better.

When it comes to monitoring doctors and the prescriptions they write, Medicare presently passes that responsibility off to private insurers that say they are ill-equipped to catch potential problems before they occur.  A majority of insurers only have access to the records of their members and cannot see what a certain physician is doing across multiple health plans.  Some critics point out that Medicare’s complacency on the issue could be putting patients at risk.

While Medicare and other federal assistance programs are designed to help those who need them the most, in some cases they may not be so.  In some cases, it would appear as if the program is not protecting disabled and elderly patients from suffering serious harm at the hands of physicians only looking to receive a paycheck in the end.

Source: The Jackson Free Press, “Medicare Drug Program Fails to Monitor Prescribers, Putting Seniors and Disabled at Risk,” Trace Weber et al, May 16, 2013