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goldielocks……………Compounding Pharmacies

Posted by overton @ 12:37 on March 5, 2016  

the problem is there is a Compounding pharmacy scam that’s been very lucrative for medicare fraud

 

what happens….someone calls my elderly mother implying they are from her healthcare provider asking how she is feeling, asking her if she has been having any aches or pains.  Most people pushing 90 have some kind of pain so they are willing to talk to the person and eventually cough up their doctors name.  They send a fax to their doctor ,  he looks at the request approves it for some compounding cream with  lidocaine and prilocaine in it figuring its better than taking vicodin.   Then 3 tubes of this come in the mail and the insurance company gets billed $2500 for three tubes of this cream that you could buy at walmart for less than $10.   When you call your healthcare provider they don’t really care as medicare picks up most of the cost and with the providers discounts their losses are small compared to medicare.   Your portion of the bill ($45 in this case) never comes because it would be easy to catch them.    When you try to report fraud to medicare you insurance company dumps you into a voice recording to tell the story all over again and I never heard anything back from them.

I take this $2500 cream to her doctor and he says that he typically approves requests as patients may want a knee brace or something they read about and if he thinks it may help them he’ll approve the request.  He never see the price.   I have heard some people have been taken for $10k for similar compounded creams.

6 billion in medicare fraud in 2015…………the bads ones ruin it for everyone.   Her shipment came from Tenn and I called them and they say they are just filling prescriptions

 

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Post by the Golden Rule. Oasis not responsible for content/accuracy of posts. DYODD.