Cummings Investigates “Staggering” Claims For Prescription Nutritional Supplements
Washington, D.C. (Aug. 31, 2015)—Today, Rep. Elijah E. Cummings, Ranking Member of the House Committee on Oversight and Government Reform, sent letters to Warner West Pharmacy & Supplies and CVS Health after CBS News reported that the pharmacy submitted an insurance claim for more than $44,000 on behalf of one of its customers for a widely available nutritional supplement known as Resveratrol—an antioxidant derived from grapes that the pharmacy reportedly sells over the counter for about $600.
“If these reports are accurate, they raise a host of troubling questions about how this could have occurred—and whether it is still occurring on a much wider scale,” Cummings wrote.
Cummings’ letter references new documents he has obtained, including a printout from the pharmacy’s management program that appears to confirm that the pharmacy submitted this astronomical claim, but then reversed course after press inquiries about the charges. The pharmacy apparently attributed this reversal to the patient, who the pharmacy said had “refused” the prescription. In fact, it appears that the patient was given the prescription at no charge after press inquiries were made.
Cummings’ letter also referenced a pre-printed prescription form that the pharmacy apparently used to encourage doctors to prescribe nutritional supplements sold by the pharmacy. The form includes five options with boxes next to each option that doctors could check to indicate their prescriptions. If a prescription was not covered by insurance, the pre-printed form appears to authorize the pharmacy to substitute claims for any of the other supplements—even if doctors never prescribed them.
Cummings requested that Warner West and CVS Health provide information about the submission of this insurance claim and any other similar claims, including if they were approved or reversed; the source of any payments made to cover the cost of the supplements; all National Drug Codes or other codes used to submit the claims; and the pharmacy’s use of pre-printed prescription forms that allow it to submit claims for supplements that were not prescribed by physicians.
Click here to see the letter to Warner West Pharmacy & Supplies.
Click here to see the letter to CVS Health.