Prescribing unnecessary drugs and medication
Almost 11 percent of last year’s healthcare fraud cases involved the prescription of unnecessary drugs by medical providers. In some cases, however, it is the patients to go from one doctor to another asking for medication, with physicians or pharmacists having no idea that the same patients have also visited other medical providers before them.
Unnecessary prescription of medication results in the diversion of pharmaceutical drugs, the unlawful transfer of “regulated pharmaceuticals from legal sources to the illicit marketplace” as in the study called “Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations”. According to the Drug Enforcement Administration (DEA), prescription drug diversion has turned into a $25 billion-a-year industry. The most overprescribed drugs are painkillers, with their street value 10 times higher than their legal prescription value.
In one fraudulent scheme, a physician in the Western District of KY was involved in an illegal distribution of controlled substances, which brought him 8 years and 4 months of jail time. Another fraudster, a pharmacist this time, modified the quantity listed on received prescriptions for painkillers, altered the patients’ documents and receipts and stole the extra drugs to sell them for personal profit. The fraud possibilities are endless.
