Fraud News August 2003


I’ve gathered together some information I think you’ll find useful. If you’ve got suggestions for future topics, please let me know. If you’ve got news you’d like to share, please contact me.

Oxycontin Conviction

Dr. David Mitzan pleaded guilty to charges that he forged prescriptions for Oxycontin and billed his insurance company for the drugs. Oxycontin is a time-released pain reliever that is often abused and is the cause of many crimes.

You can read about Oxycontin by visiting this link

Fraud Control Under-funded

Despite the growing awareness of the vast sums lost to healthcare fraud, most systems fail to allocate fraud control on the scale required by the flow of money involved. Fraud control in the US is under-funded by a factor of 20 or more.

Fraud News May 2003


Pharmacy Kickback Guidelines

How many of your pens have a drug name on them? A pen is not valuable enough to cause suspicion of violating anti-kickback laws, but paying a physician to attend a conference might be. Today the HHS Office of Inspector General released their voluntary guidelines for pharmacy manufacturers. The 56-page document outlines what marketing practices could raise red-flags under federal anti-kickback laws.

Managed Care Fraud Control

Save $7 per $1 Invested There is a myth that there is no fraud in managed care. In fact, a large percent of managed care services are now fee-for-service. For those services, HMOs are at the same risk of fraud as other insurers. For other services, the incentives for fraud are different but still exsist.

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