Pharmacists convicted of fraud in LA

[PharmaBr0]

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This is pretty egregious:

A federal jury found two Los Angeles pharmacy owners guilty yesterday for their participation in a $35 million health care fraud and money laundering scheme to bill Medicare for medications that were never provided and to launder the proceeds of the fraud.

 

[owlegrad]

I mean all they did was create fake invoices to cover up the fact that they billed CMS for prescriptions they never actually filled and then laundered that money through the same third part.

You can make anything sound bad if you try hard enough.

OK, sarcasm aside according to this article the strike force has uncovered more than 14 Billion dollars worth of fraud since 2007. What percent of overall claims are fraudulent if that is the case?!

 

[PharmaBr0]

14 billion is *just* what they caught. Wonder how much slips by...

 

[BMBiology]

This is pretty egregious:

A federal jury found two Los Angeles pharmacy owners guilty yesterday for their participation in a $35 million health care fraud and money laundering scheme to bill Medicare for medications that were never provided and to launder the proceeds of the fraud.

They are a pharmacy owner, not necessary a pharmacist. I searched their name on the BOP website and their name didn’t come up as pharmacist.

 

[BenJammin]

So instead of actually ordering the product and then returning it, they never ordered it in the first place? That's hilarious! How did they go this long without being caught? Imagine going into a pharmacy and finding out they do millions in sales each year without a wholesaler.

 

[owlegrad]

So instead of actually ordering the product and then returning it, they never ordered it in the first place? That's hilarious! How did they go this long without being caught? Imagine going into a pharmacy and finding out they do millions in sales each year without a wholesaler.

I am actually unsure how they could ever figure it out. The wholesaler was providing fake invoices. And presumably they had real stock for prescriptions they did actually fill.

 

[lord999]

I am actually unsure how they could ever figure it out. The wholesaler was providing fake invoices. And presumably they had real stock for prescriptions they did actually fill.

Well, this probably identifies me, but if you're going to commit fraud, don't do it with thalidomide despite the high reimbursement. It's not like National doesn't track the drug. From dealing with the investigations, I've got about 25-30 tricks that are dead giveaways that someone is abusing the reimbursement process.

 

[Sine Cura]

This "strike force" pats themselves on the back for hitting Walmart due to pharmacists not documenting Medi-Cal code 1 restrictions when 1 in 3 "Californians" are on Medi-Cal. I couldn't give less of a ****.

 

[Twentytwelve2]

This "strike force" pats themselves on the back for hitting Walmart due to pharmacists not documenting Medi-Cal code 1 restrictions when 1 in 3 "Californians" are on Medi-Cal. I couldn't give less of a ****.

Our software now locks techs from doing straight medi-cal rx processing because of that