Staying Alert to Medicare Fraud in the Pharmacy

Pharmacists play an important role in protecting both patients and the healthcare system from Medicare fraud. Stay alert for unusual billing patterns, suspicious prescriptions, or requests for medications or services that seem fraudulent or medically unnecessary. If something doesn’t seem right, take a moment to verify the information and follow your pharmacy’s reporting procedures. You can also report suspected fraud by calling 1-800-MEDICARE.

Remaining vigilant is important because Medicare fraud continues to occur in healthcare settings, and recent news highlights just how serious these cases can be. For example, two men in Queens were recently charged in a $120 million scheme in which they allegedly paid kickbacks to induce beneficiaries to fill prescriptions in a pharmacy and enroll in an adult day care center. They also submitted fraudulent Medicare and Medicaid claims for services that were unnecessary or never provided. Staying alert helps protect your patients, your practice, and the integrity of the Medicare program.