An investigation into Medicare’s billing found 77 percent of the time, the drug was over-billed.
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In looking at individual states, the Inspector General found in Ohio half the billings for full vials were incorrect between 2012 and 2014, totalling $90,580 in over-billing to the federal government.
Louisiana, New York, Indiana, Arkansas, Texas and Illinois Medicaid programs have had similar findings.
The OIG has asked the state to recover the overpayments from providers and to update its billing system so that multi-use drugs like Herceptin are billed properly.
Ohio’s Department of Medicaid responded to the report saying more than $71,000 has already been recovered and the state is educating providers so the drug is billed properly.
The state argues that only 2.5 percent of all Herceptin claims during the investigation period were incorrect.
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