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OIG: Medicare spent $7 million on improper pneumococcal shots

NEWS IN BRIEF — Posted July 8, 2013

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More than 122,000 Medicare beneficiaries have received multiple pneumococcal vaccinations within a five-year period despite frequency recommendations advising against the practice, according to a June 25 report by the Dept. of Health and Human Services Office of Inspector General.

Current standards advise Medicare patients 65 and older to have a pneumococcal shot followed by a second vaccine five years later. Medicare spent $7 million for multiple vaccinations to patients between 2007-11.

“The data also suggest that 43% of the unnecessary vaccination could be reduced through providers reviewing the medical histories of established patients,” the OIG report stated. “Tools, such as electronic medical records, may assist in this effort.”

The OIG also identified locations of some of the 25,000 clinics, home health providers and physicians violating the accepted vaccination practices. For instance, a home health operation in Columbia, Md., was responsible for 754 beneficiaries with repeat vaccinations.

Medicare paid a total of $234 million for pneumococcal vaccines that covered 4.6 million beneficiaries from 2007 to 2011.

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