Alerting other pharmacists about fraud RX

[Digsbe]

I had a patient today. They presented meds and 1 of them was a control. No dates on the scripts. We had to call the MD to verify dates and get a verbal for the control. We told the patient we called and she said she'd go to our competitor next door. I warned the competitor that dates were missing and we called the MD. Patient found out because the competitors led on that they got a tip and she just wrote dates on their RX (which is tampering with a controlled substance prescription and a felony). Patient calls me cursing me out demanding my name for a lawsuit and ends the phone call ending it with libel saying I was being racist and also wished that I would die in a violent car accident. I told her to call corporate to file any complaint and refused to give her my full name. Anyone else been in a similar situation? What's the right thing to do? I warned my competitor about fraud as a professional courtesy and he called her out on tampering and now she's accusing me of racism and wanting a lawsuit. I knew she was just going to write dates on there herself and gave a heads up to a competitor colleage (and that's exactly what happened). Now she wants to sue me for racism and states I had I had no right to contact my competitor regarding the missing date issue that she just wrote on herself. To my knowledge if we suspect fraud we are to warn others or report it to police per DEA guidelines . Just wondering how others handle these situations.

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[zelman]

I had a patient today. They presented meds and 1 of them was a control. No dates on the scripts. We had to call the MD to verify dates and get a verbal for the control. We told the patient we called and she said she'd go to our competitor next door. I warned the competitor that dates were missing and we called the MD. Patient found out because the competitors led on that they got a tip and she just wrote dates on there RX (which is tampering with a controlled substance prescription and a felony). Patient calls me cursing me out demanding my name for a lawsuit and ends the phone call ending it with libel saying I was being racist and also wished that I would die in a violent car accident. I told her to call corporate to file any complaint and refused to give her my full name. Anyone else been in a similar situation? What's the right thing to do? I warned my competitor about fraud as a professional courtesy and he called her out on tampering and now she's accusing me of racism and wanting a lawsuit. I knew she was just going to write dates on there herself and gave a heads up to a competitor colleage (and that's exactly what happened). Now she wants to sue me for racism and states I had I had no right to contact my competitor regarding the missing date issue that she just wrote on herself. To my knowledge if we suspect fraud we are to warn others or report it to police per DEA guidelines . Just wondering how others handle these situations.

You did nothing wrong. Don't worry.

When an RX is invalid, I write on it. Circle the area where the date or signature or whatever should be and write "NO DATE" by the circle. End of story.

 

[mentos]

If the scripts were invalid why didn't you cross them out and write void on them? We don't even hand them back to the customer, the doctor usually tells us to trash them.

We get threatened with corporate complaints and "you'll be hearing from my lawyer!" all the time. Let them complain.

 

[TheWisePharmacist]

Like everyone else said you either.
1. Write void on script and note the issue and do not hand it back
or
2. Write void on script and note the issue and hand it back.

*Generally I think you keep it, but you should consult with your companies policies to be sure. If I remember correctly the pharmacy maintains a California folder of fake prescriptions or their copies with documentation.

 

[Z-Qualizer]

I had a patient today. They presented meds and 1 of them was a control. No dates on the scripts. We had to call the MD to verify dates and get a verbal for the control. We told the patient we called and she said she'd go to our competitor next door. I warned the competitor that dates were missing and we called the MD. Patient found out because the competitors led on that they got a tip and she just wrote dates on there RX (which is tampering with a controlled substance prescription and a felony). Patient calls me cursing me out demanding my name for a lawsuit and ends the phone call ending it with libel saying I was being racist and also wished that I would die in a violent car accident. I told her to call corporate to file any complaint and refused to give her my full name. Anyone else been in a similar situation? What's the right thing to do? I warned my competitor about fraud as a professional courtesy and he called her out on tampering and now she's accusing me of racism and wanting a lawsuit. I knew she was just going to write dates on there herself and gave a heads up to a competitor colleage (and that's exactly what happened). Now she wants to sue me for racism and states I had I had no right to contact my competitor regarding the missing date issue that she just wrote on herself. To my knowledge if we suspect fraud we are to warn others or report it to police per DEA guidelines . Just wondering how others handle these situations.

Just curious... what is usually the threshold for contacting law enforcement?

 

[politeness]

Good advice. I will look out for that now.

 

[wagrxm2000]

Just going to toss this out there. Our dm told us a awhile back never to write anything on a script unless it's filled to protect ourselves. Naturally no one listens but curious if others have been told the same.

 

[6GodPharm]

I'll take our Lawyers over the $2 hooker lawyers these "no copay" people can probably afford. I wouldn't stress.

 

[TheWisePharmacist]

Just going to toss this out there. Our dm told us a awhile back never to write anything on a script unless it's filled to protect ourselves. Naturally no one listens but curious if others have been told the same.

-I've never heard this before, especially since for controls we:
1: Write down the drivers license on the script
2: place the date of birth on script (all scripts)
3: Place the address on the script

-Sometimes patients ask for scripts back since they find it cheaper somewhere else and you have already written on it. It may be a company/district specific policy maybe because something happened in the past?

Just curious... what is usually the threshold for contacting law enforcement?

-I would go with company policy on this, but my understanding is that in most cases its an individual judgement call.
-My first Monday working as a pharmacist I called the cops on a patient for a fake script. I called the physicians office and they stated they never saw the patient before and told me to go ahead and call the police. I talked with the pharmacy supervisor later and he told me to keep a record of it in the pharmacy. I know there was a continued learning module on it for work, but all I remember was that the 1st choice wasn't to call the cops.

 

[Digsbe]

Just curious... what is usually the threshold for contacting law enforcement?

When it left my pharmacy it wasn't tampered. She added dates before going to the next one sof it became tampered at that point. When I called that pharmacy I just mentioned the 3 drugs and the office (no call back number on the scripts. Had to Google for one) and made sure not to give the name just in case of a HIPAA issue.

 

[ChalupaBatman86]

Don't let your Justice boner add to your stress level and workload. It had a missing date and she took it someplace else, who cares.


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[owlegrad]

I am with Batman. The prescriber forgot to write the date, big deal. Hardly worth concerning yourself with after giving the script back, IMO. Heck I can see myself committing this 'felony' if my doctor made the same mistake.

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[crossurfingers]

At one of the pharmacies I work at, we scan the hard copy into the system, print out a copy and write down why we refused the rx and place it in a file. We then give the rx back to the patient if we cannot immediately prove that it is fraudulent.

 

[catalyzt]

Just going to toss this out there. Our dm told us a awhile back never to write anything on a script unless it's filled to protect ourselves. Naturally no one listens but curious if others have been told the same.

I think that policy is WAGS-specific. My sup told me the same thing years ago when I worked there.

 

[6GodPharm]

Don't let your Justice boner add to your stress level and workload. It had a missing date and she took it someplace else, who cares.


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I agree, on those we just give it back to the customer and let them know such and such is missing. I don't care who fills it or what the patient does with it.

 

[sosoo]

these pharmacists are brave. i been with cvs since 2011 and i never seen anyone dare to X out an invalid c2, write VOID on it, etc... might as well rip that piece of trash in their face and see what they do!

 

[zelman]

these pharmacists are brave. i been with cvs since 2011 and i never seen anyone dare to X out an invalid c2, write VOID on it, etc... might as well rip that piece of trash in their face and see what they do!

I ripped an Rx to confetti because the patient wouldn't leave without it. It was "written" during a blizzard when the doctor's office was closed. She took the baggie of Rx bits and left.

 

[TheWisePharmacist]

I ripped an Rx to confetti because the patient wouldn't leave without it. It was "written" during a blizzard when the doctor's office was closed. She took the baggie of Rx bits and left.

Lol! Generally if your 100% sure it's a fake prescription, "I'll call the police, if you don't leave" are the magic words to say, but since there was a blizzard it may have caused you to improvise.

 

[CetiAlphaFive]

I don't think there is any legal standing for keeping a prescription that you haven't filled if a patient demands it back.
I may be wrong, but I always just make a copy for my "refusal to fill" file and give it back. My writing or stamp will be somewhere on the hard copy.

Furthermore:
The specific crime this patient committee is called "uttering"

Interesting stuff.

I had a patient today. They presented meds and 1 of them was a control. No dates on the scripts. We had to call the MD to verify dates and get a verbal for the control. We told the patient we called and she said she'd go to our competitor next door. I warned the competitor that dates were missing and we called the MD. Patient found out because the competitors led on that they got a tip and she just wrote dates on their RX (which is tampering with a controlled substance prescription and a felony). Patient calls me cursing me out demanding my name for a lawsuit and ends the phone call ending it with libel saying I was being racist and also wished that I would die in a violent car accident. I told her to call corporate to file any complaint and refused to give her my full name. Anyone else been in a similar situation? What's the right thing to do? I warned my competitor about fraud as a professional courtesy and he called her out on tampering and now she's accusing me of racism and wanting a lawsuit. I knew she was just going to write dates on there herself and gave a heads up to a competitor colleage (and that's exactly what happened). Now she wants to sue me for racism and states I had I had no right to contact my competitor regarding the missing date issue that she just wrote on herself. To my knowledge if we suspect fraud we are to warn others or report it to police per DEA guidelines . Just wondering how others handle these situations.

I'd follow DEA guidelines if I were you.

Just curious... what is usually the threshold for contacting law enforcement?

I discussed this ad nauseamuseum in my "recognizing a patient" thread.

 

[Charcoales]

Just give it back if you don't want to fill it, simply too busy to be calling all the competitors/Dr offices

 

[Digsbe]

I don't think there is any legal standing for keeping a prescription that you haven't filled if a patient demands it back.
I may be wrong, but I always just make a copy for my "refusal to fill" file and give it back. My writing or stamp will be somewhere on the hard copy.

Furthermore:
The specific crime this patient committee is called "uttering"

Interesting stuff.


I'd follow DEA guidelines if I were you.





I discussed this ad nauseamuseum in my "recognizing a patient" thread.

I reviewed the guidelines, if I'm not mistaken we have a professional obligation to prevent fraud. I did give the RX's back to the patient but they had a few red flags in that the location was stamped on there, there was no call back number, and obviously none had dates. No call back and no date is something most practitioners wouldn't neglect to put on there. I never gave the patients name, just the practice. I know her empty death threats and racism accusations are bogus, and she has no case in court, but if I'm not mistaken don't we have an obligation to try and prevent fraud and drug diversion on controls? Adding a date to a controlled substance RX when you know it's missing is illegal.

 

[zelman]

I don't think there is any legal standing for keeping a prescription that you haven't filled if a patient demands it back.

This varies by state. In some states where prescriptions must be on a specific state-supplied blank (like NY was pre-eRx mandate) the prescription is actually property of the state.

I discussed this ad nauseamuseum in my "recognizing a patient" thread.

This is different. Forged prescriptions are not protected by HIPAA at all as they are not part of the patient's medical record. You can contact police all you want for forged/altered Rx's.

 

[Z-Qualizer]

I discussed this ad nauseamuseum in my "recognizing a patient" thread.

Thanks, I'll check it out!

 

[CetiAlphaFive]

This varies by state. In some states where prescriptions must be on a specific state-supplied blank (like NY was pre-eRx mandate) the prescription is actually property of the state.

This is different. Forged prescriptions are not protected by HIPAA at all as they are not part of the patient's medical record. You can contact police all you want for forged/altered Rx's.

I agree.
Even if it's not technically a forgery, it took place on the premises of OP's pharmacy, so they're golden either way.

[Insert thumbs up memeoji here]