Earlier this year, the US Senate Finance Committee wrote to the US Department of Health and Human Services to complain that the agency wasn’t properly investigating complaints about pharmacies that are, essentially, fly-by-night operations and are billing millions of dollars to Medicare and private insurers - and then disappearing.

Examples included: A Miami area pharmacy billed an insurer $26,000 for antipsychotics and inhalers during a three-day period, but the owners soon disappeared and the store was abandoned. A Los Angeles pharmacy billed $1.3 million under the Part D program over 18 months, more than double the Rite Aid pharmacy blocks away. Another Miami pharmacy billed an insurer $245,000 in false claims in less than three months, and the owner later bought a one-way ticket to Europe. In an April 5 letter to HHS, Chuck Grassley, an Iowa Republican and the committee’s ranking minority member, wrote that one private insurer repeatedly called the Centers for Medicare & Medicaid Services, but never received a response.

However, Marilyn Tavenner, the CMS acting administrator and chief operating officer, did respond to Grassley, but did so in a way that ticked him off. In her June 18 reply, which was just released, Tavenner writes that “the circumstances you outline are inconsistent with our complaint management procedures,” and adds that seven of the eight pharmacies Grassley previously identified were already under investigation. In other words, thanks, Chuck, but we don’t need your help.

And so Grassley let loose with his own reply. “CMS’s one-page letter made no attempt to answer any of the requests,” he wrote to HHS Secretary Kathleen Sebelius in a Sept. 14 letter (see the back-and-forth letters here). “It is telling that a department letter regarding concerns of unresponsiveness would be so, frankly, unresponsive. This is unacceptable…” From phantom pharmacies to phantom inquiries?