-Caveat Lector-
MASHANTUCKET, Conn.(AP) - A wealthy Indian tribe that runs the
world's largest casino abused a government health program
intended for American Indians by dispensing $5.8 million in
discounted prescription drugs to its non-Indian casino employees,
a federal audit says.
The audit found that 82 percent of the drugs dispensed under the
program by the Mashantucket Pequot's pharmacy in 1998 and 1999
went to ineligible patients.
In response, the federal Indian Health Service said it will
review all prescription drug contracts with tribes across the
country. The service said it will also instruct the Mashantuckets
to stop including non-Indians in the program.
Tribal spokesman Arthur Henick said Monday that the Mashantuckets
disagree with the audit's conclusions and may appeal to top
health officials in Washington. He said there are no immediate
plans to scale back the drug program, which he said allows the
tribe to provide prescription medicine at no cost to its
employees.
The Mashantuckets run Foxwoods Resort Casino, which takes in
upwards of $1 million a day in gambling revenue. There is no
suggestion the tribe profits directly from the sale of the drugs.
However, on its Web site, Foxwoods touts its ``no-cost
prescription program with onsite delivery'' as a job benefit.
Health officials expressed concern that including non-Indians who
work in tribal businesses could jeopardize the future of the drug
discount, which some poorer tribes count on for affordable
prescription medicines.
``Evidence of program abuse could prompt Congress to reconsider
the future of discounted drug programs, which would ultimately
affect the millions of federal beneficiaries who now depend upon
them for their health care,'' June Gibbs Brown, the U.S. Health
and Human Services Department's inspector general, wrote in an
Aug. 17 memo to the head of the Indian Health Service. Brown's
office conducted the audit.
Under the Veterans Health Care Act of 1992, the Veterans Affairs
Department, the Pentagon, the Coast Guard and the Public Health
Service are entitled to buy drugs from suppliers at deeply
discounted rates - often less than 50 percent the regular price.
The Indian Health Service, a unit of the Public Health Service,
extends this service to tribes that have ``self-determination
contracts'' with the government.
Tribes can then provide the discounted drugs to their own
members. But the law says the drugs may be dispensed to
non-Indians only if ``there are no reasonable alternative health
services available.''
The Mashantucket tribe has about 600 members, plus 12,000
employees at its casino, hotels, restaurants and museum. Together
with their dependents, about 22,000 people, almost all of them
non-Indians, are covered under the tribe's prescription drug
plan, auditors said.
Auditors said that because there are at least 40 drug stores
within 10 miles of the reservation, the tribe cannot claim a lack
of alternative health services.
The auditors also dismissed the tribe's contention that the
Indian Health Service was aware of its practice of selling drugs
to non-Indians, saying that even if it were true, the health
service does not have the authority to approve it.
Casino employees said the tribe's prescription drug benefit was
unusually generous and would be sorely missed.
Leo Jackson, a shuttle bus driver who said he lost his medical
coverage while employed at Electric Boat in Groton years ago,
said he requires three prescriptions for cancer treatment.
``There's no way I could afford to pay even for part of this
stuff I have to take,'' Jackson said. ``I don't know what I'll do
if the plan disappears.''
Henick said the Mashantuckets do not consider the inspector
general's report the final word on the matter.
``The tribe has been able to provide one of the best health plans
in the region for its employees,'' Henick said. ``We're going to
continue to do anything we can for our employees, whom we
consider part of the tribe for purposes of health care.''
Although the inspector general's report concentrated on the
Mashantuckets, it found reason to believe the alleged abuse may
involve other tribes.
The report noted that in August 1999, a consortium of 11 tribes
in Michigan and Wisconsin requested advice on the legality of
providing discounted drugs to non-Indians, indicating that they
believed they could do so. It was not immediately clear whether
the tribes received a reply.
In addition, the Mashantuckets contract with 16 other tribes to
provide mail-order pharmaceutical services. Auditors contacted
six of the tribes and found that four of them include non-Indian
employees among those who receive discounted drugs from the
Mashantuckets.
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Shalom, A Salaam Aleikum, and to all, A Good Day.
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