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Tuesday, January 05, 2010

Citizens Alert Reference Prescription Fraud

Location: State of Delaware

Date and Time: Ongoing

Resume: Prescription fraud has been an issue in Delaware for quite some time. Investigators from various agencies, including the Delaware State Police Office of Narcotics and Dangerous Drugs, work diligently to combat this problem using multiple approaches including education, enforcement, and legislation.

A recent trend has come to light that has made it all too easy for suspects to manufacture a fraudulent script. This specifically has to do with what patients do with the bag and literature their prescriptions come with.

It is common knowledge that once a script is filled, the pharmacist places the medicine in a bag. He or she will then attach an informational sheet which often times contains a plethora of information such as the patient’s name, date of birth, doctor writing the script, what the medicine is and the dosage.

Investigators have learned that fraud suspects have been rooting through public trash cans in or around pharmacies to look for these informational sheets that some patients have so carelessly thrown away as they left the store. These sheets contain all the data a prescription fraud suspect may need to forge a script.

Here is an example. Let’s say a patient goes to pharmacy #1 to have a script legitimately filled. On their way out of the pharmacy, they take their medicine bottle out of the bag and discard the bag and informational sheet in the public trash can in front of the store. Along comes a prescription fraud suspect, and, as they’re rooting through the trash cans, they find the discarded info sheet.

With certain knowledge, the prescription fraud suspect could use that information to forge another prescription- again using the actual patient’s name. The suspect could then go to pharmacy #2 and have the bogus script filled. If the pharmacy were to call the doctor to check on the validity of the prescription, it would seem legitimate.

The caper could soon, however, be uncovered if an insurance company or benefit provider were to see a double billing for the same script. This sometimes happens sooner than later as pharmacies often times immediately contact the insurance or benefit provider at the time the prescription is processed.

The answer to this issue is simple; patients need to protect their identity and their personal information by properly disposing of these informational sheets. These informational sheets should be treated with the same sensitivity as one would treat their bank statement. Pharmacies are encouraged to stress the importance of protecting this information with their customers.

Prescription fraud suspects should be warned; investigators are on to this trend and will hold those who are identified accountable for this felonious offense.

7 comments:

justmyopinion said...

Call me anal, but i always shred that info and also tear the label off the prescription bottle.

Anonymous said...

My wife and I had a run in several years ago with fraudulent prescriptions. My wife was sick over a weekend and the Dr. called in a prescription to a national drug store (not our usual choice, but it was Sunday). On getting the prescription, we noticed that it was a narcotic not an antibiotic (my wife cannot take narcotics due to other health concerns). In questioning the pharmacist, we were told that it was called in within the hour and that the patient needed it immediately due to serve pain. To make a long story short, over the next few days we discovered 9 fraudulently obtained prescriptions on our plan, all obtained using our prescription plan and co-pay ($5.00 to $15.00). We filed a police report the next day. Over the course of two days, the prescription wasn’t picked up and I had noticed someone I knew in the pharmacy. I called the local police to discuss and they requested that my wife and I meet with them as they had some information. I relating my story of the acquaintance in the pharmacy, they informed me that when they called me in the same person was a suspect. Since they had no direct evidence the person would not voluntarily come in and for 1 year nothing happened. By a chance conversation with another police officer in a nearby town, my information was used to break the case. Unfortunately, the suspect we had in my case only received PBJ. To make matters worse, I work for the State of Maryland and my wife in health care. Both of us could have lost our jobs due to the "seemed abuse" of narcotics. I battled the state of Maryland and my prescription plan provider for over 2 years to have the fraudulently obtain prescriptions removed from our names, and only then was it removed after a conversion with a former Governor. Believe me, it pays to check your prescription provide every month or so to catch this type of activity. Regardless of what anyone tells your, HIPA laws do not protect anything false or fraudulent and that you must fight to have this understood.

Anonymous said...

The pharmacies could start asking for proof of identification....I'd say that's probably the strongest proactive step that could be taken.
Heck, I have to show my ID to use my bank card or to write a check, why not to fill a prescription?
In the case of where my husband fills prescriptions for his mother, that information is on file that he does this as POA. Even then they should require him to produce his ID.
I believe this one is THIS simple to fix!

Anonymous said...

You know this really pisses me off. It is the people that are being dishonest that make it so difficult for those of us who need pain medication. I see pain management at John Hopkins. Believe me when I tell you that their rules are very strict. They will make recommendations to your primary care physician and then your primary care physician writes the scripts for the meds they recommend. The other problem I have is the pharmacies themselves. I stopped using a particular pharmacy in Berlin (I won't name it, but I really should). My doctor would call in meds for me. Every time I would call and ask if it had been phoned in, they would say no. So I would call the doctor's office and was told they had been called it in. Then mysteriously the next day when the pharmacy opened, the prescription had been filled the night before. Hello!!! Listen to your freaking messages. I found them to be lazy and rude. So I stopped using this pharmacy. Been using a different pharmacy ever since and I haven't had a problem. The prescription is always ready within an hour or so. It just makes it a pain in the butt trying to deal with the rules for pain meds. There has to be a different approach that can be taken for fraud. It just infuriates me that I am an honest person who plays by the rules and these dumb a$$es are out here are making life more difficult for us. I think doctor's offices should not leave their prescription pads in the rooms any more either. I know that every time I have to see the doctor that they pull the prescription pad from out of a drawer in the room.

Anonymous said...

I, too, am very cautious with the "leaflet" that comes attached to any of my prescription meds -- simply because it DOES have my name and other info. on it. I've often thought it wouldn't take much for someone to use that info. to their advantage. It's unfortunate, but in this day and age, you can't be too careful. I shred practically EVERYTHING -- especially credit card offers -- that could be used by someone else in a fraudulent manner. You have to be proactive.

Anonymous said...

I too have had problems with pharmacy employees but not in Berlin. My experiences have been in Salisbury. I will not go into all of the details, but in general, use a pharmacy that is privately owned. I use Eastern Shore Pharmacy located opposite the hospital on Rt 13. They are great people there. If you are a regular, they know your name when you walk in. How many places can say that know their customers? They are friendly and efficient. Many of the big box pharmacies pump out prescriptions like a factory. At Eastern Shore Pharmacy, they really care about their customers. Give them a try if you are having problems with your pharmacy.

Anonymous said...

how naive... it's a whole lot easier than that to fake a script.