Prescription drug fraud is a specific variety of drug offenses that involves individuals obtaining medications from physicians by means of deception. One common way that people execute prescription medication fraud is by using forged prescriptions. Other individuals may go “doctor shopping” until they find a doctor who is willing to prescribe the medication that they desire.
Almost 15,000 people die each year due to overdosing on prescription medications. According to Blue Cross Blue Shield, the majority of prescription drug fraud is in the south of the United States even though it is endemic across the nation.
What are the general signs of prescription drug fraud?
It is common for individuals engaging in prescription drug fraud to have multiple prescriptions from a variety of different doctors. Often, these prescriptions represent a wide gamut of medications, and they are most likely to be painkillers, opioids or tranquilizers.
Individuals who frequently travel to pharmacies located far from the place they live may be engaging in prescription drug fraud. From the doctor’s side, a physician who is doling out large volumes of prescriptions to patients without a diagnosis consistent with said prescriptions is a red flag.
How are insurance companies fighting against prescription drug fraud?
Most health insurance companies devote a large amount of time to analyzing medical claims. This helps zero in on patients and physicians engaging in questionable practices. For instance, if an individual gets 10 or more prescriptions for controlled medications within three months or less, this is an indication of prescription drug fraud.
However, insurance companies are likely to first assign a case manager to individuals. It is possible for individuals to be on large amounts of painkillers without engaging in fraud.