According to the USDOJ press release -
Evidence presented at a six-week jury trial concluding in August 2012 showed between 2006 and 2011, the pharmacies billed Medicare and Medicaid more than $57 million. At least 25% of those billings were for drugs that were either medically unnecessary never dispensed. Additional amounts were fraudulently billed to private insurers such as Blue Cross Blue Shield of Michigan.I know that I've discussed this topic before, and probably will again, but if this USDOJ press release doesn't illustrate the legal consequences of difficult choices a healthcare professional faces in the workplace every day, and learning to say "NO!" when it's appropriate, then I don't now what else will.
The pharmacies operated on a business model that paid kickbacks to physicians in exchange for writing prescriptions for expensive medications. The affiliated doctors would also write prescriptions for controlled substances, without regard to medical necessity, which would be filled at the pharmacies and distributed to paid "patients" and patient recruiters. The expensive non-controlled medications would be billed but not dispensed.
Of the 26 defendants charged in the original indictment in this case, 20 defendants have either pleaded guilty or been convicted at trial. Six defendants are scheduled for trial in June. Out of 12 pharmacists charged, 11 have been convicted at trial or pleaded guilty, with one waiting to be tried. Out of four doctors charged, two have pleaded guilty, with two waiting to be tried. (my emphasis)
Attempting to rationalize poor choices by saying "Everyone else is doing it.", using the excuse that "I'm just doing my job." or that "I'm just a professional following orders." isn't going to save your ass.
I understand that there a lot of inequities in both the healthcare and judicial systems, and that you may be thinking that you're in desperate financial circumstances, but the Government is CRACKING DOWN HARD on both healthcare fraud AND prescription drug abuse. Don't let our job defeat you.
Make the right choices and don't put yourself in a position that you may later come to regret.
In a statement of facts filed with his plea agreement, Larren Wade, 55, admitted that between March and July 2010, he issued thousands of prescriptions for pain medications, sometimes exceeding 2,000 pills per patient each month. Wade frequently issued these prescriptions without conducting a physical examination, without reviewing prior medical records, and without establishing a treatment plan.
ReplyDeleteDuring this time, Wade also operated an almost strictly cash business and would typically see between 30 and 50 patients per day, but in at least one instance saw more than 100 patients in a single day and collected nearly $10,000 in cash.
Source: DEA - Former Alexandria Doctor Pleads Guilty to Conspiring to Distribute Oxycodone
It's hard to believe that there are still some "rogue" pharmacists making crazy choices.
ReplyDeleteAccording to excerpts from a recent DEA news release out of New Joisey, Manhattan U.S. Attorney Preet Bharara said: “As alleged, these nine defendants, including three licensed pharmacists, created and operated a ring for the illegitimate distribution of prescription painkillers on the East Coast. Prescription drug abuse is our nation’s fastest-growing drug epidemic, and it is especially egregious when, as alleged in this Indictment, health care professionals perpetuate this danger to society.”
DEA Special Agent-in-Charge Carl J. Kotowski said: “Today, DEA and its law enforcement partners delivered another blow to alleged rogue pharmacists who choose to sacrifice their ethics for the almighty dollar. They will now have to deal with the consequences of their alleged decisions.”
I'm telling you, you can't escape Big Brother. If you're going to work for a non-pharmacist-owned pharmacy, better learn how to say "NO!" to excessive greed beforehand, and stand your ground.