Tennessee Pharmacist Indicted for Fraud

Tennessee Pharmacist Indicted for Fraud:

The recent case in Tennessee involving a Pharmacist indicted for fraud should make us all consider a thorough review of all our Pharmacy’s policies and procedures (or perhaps the lack of documentation that every Pharmacy is required to have). Although the purpose of this post is in no way intended to compare honest Pharmacy business owners with the Tennessee Pharmacist who was arrested and charged with TennCare fraud and selling fraudulent prescriptions, we at HCC have always believed in the old cliche “an ounce of prevention is worth a pound of cure”. This is more relevant today than ever in the evolving world of technology that makes having up to date policies, procedures, processes and documentation a mandatory necessity.

The case in Tennessee  involves a 76 year old Pharmacy owner charged with 25 counts of TennCare fraud. Following a six month investigation, it became clear that the Pharmacy was billing TennCare for drugs that were never dispensed to patients. As just one example, agents said that TennCare was billed 9 times for a total of $7,857.85 for Abilify (an antipsychotic medication used to treat schizophrenia). Followup during the investigation led the investigators to numerous other violations. Although this is obviously an extreme example of “one thing being looked at leading to another”, the investigators also uncovered controlled substance inventory discrepancies of roughly 195,000 controlled substance pills that were unaccounted for by inventory documentation.

The important conclusion to consider from this case is that when inspectors or investigators are focusing on one area of your business, the potential of uncovering deficiencies in other areas of your practice exists. Being Pharmacists ourselves, we at HCC know that the majority of all Pharmacy owners are extremely honest, hard working individuals who do the best job possible to adhere to all laws, standards and best practices. Yet each of us must ask ourselves: “Am I really doing this? Am I an expert on all the regulations, laws and standards that are constantly changing? Am I qualified to determine if my policies, procedures and documentation are adequate?”. If not, when was the last time that what you do have in place was reviewed by a qualified Compliance Expert or Pharmacy Consultant? If the answers to any of the questions was no, we strongly urge you to call HCC today for a free consultation at 800-642-1652. HCC is a full service Pharmacy Consulting firm that has been in business for over 27 years helping pharmacies plan, prepare and deal with issues before they become problems.


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Consulting For Online and Internet Pharmacies – Policies & Procedures

Online Pharmacies have been a controversial issue for decades now. The recent charges against a Pharmacy owner and a doctor regarding an illegal Internet “scam” they ran to make millions by distributing medications to patients without valid prescriptions again brings this topic to national attention. The fact that the “scam” went on for almost 4 years is leading many legislators and consumers to voice their concerns for both better regulations and monitoring regarding Internet Pharmacies.

The basis of the indictment is that patients received prescription drugs through RX Limited and other websites by simply filling out online medical forms and then hitting the “submit” button on a website! Then pay and check out and the prescriptions arrive. Utilizing both his Anaconda Pharmacy and his MEDS 2 GO Pharmacy businesses, Philip E. Michael II, of Alum Creek, West Virginia, filled and shipped Rx drug orders to patients throughout the United States without valid prescriptions. After patients selected desired drugs and submitted an online medical questionnaire, the website would send it to doctors such as Eutan Laing, of Piscataway, New Jersey, who has also been charged. The drugs would then be dispensed and shipped without having an adequate patient history, performing any patient exams, nor using any appropriate diagnostic or laboratory testing. Then, the invalid prescription would be filled by MEDS 2 Go or Aracoma and shipped to customers.

According to the National Association of Boards of Pharmacy (NABP), 97% of almost 11,00 online pharmacies reviewed by the board are operating in conflict with pharmacy laws and practice standards. Violations have included stolen personal and financial information, virus-laden spam e-mails and even online pharmacies selling pills that contain drywall or rat poison. Some of the issues surrounding Internet pharmacies were highlighted by a case in 2012 involving a couple of Canadian businessmen who sold counterfeit Avastin, a cancer drug developed by Roche Holding AG, to Americans patients. Some of these counterfeit medications even showed up in medical clinics. In 2014, FedEx received an indictment from a federal grand jury for drug trafficking charges after delivering drugs for nearly a decade from Internet Pharmacies operating illegally. As recently as early March, there was a $2 million settlement paid by one Missouri pharmacist who distributed painkillers like Fioricet online to patients he had never seen for an in-person consultation.

In this particular case. Michael and Laing have been charged with a list of criminal charges that is almost too long to even comprehend:
– Internet pharmacy conspiracy to distribute misbranded drugs.
– Distributing misbranded drugs
– Mail fraud conspiracy
– Wire fraud conspiracy
– Health care fraud
– Engaging in the unlicensed wholesale distribution of prescription drugs
– Defrauding a health care benefit program

If you plan to open an Internet Pharmacy or currently operate an Online Pharmacy, the time to make sure that you are doing everything right and legally is now! The security requirements alone that are required are vastly complex and complicated and even without intentionally meaning to, violations such as aggravated identity theft have been filed against several Internet Pharmacies.

As always, please contact us here at HCC if you have questions regarding establishing or running an Internet Pharmacy online. With over 27 years in the Pharmacy Consulting business, HCC can assist with expert advice in any area of your pharmacy business or practice. We urge you to contact us today to see how our Pharmacy Consulting services can help. With a full-time staff of in-house Pharmacy Consultant specialists, HCC can answer any questions that you may have in all areas of your business. Call us today at 800-642-1652 for a free consultation.

 


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