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Prescription Drug Fraud

With the Advent of the opioid epidemic, prescription drug fraud is quickly becoming the top priority within the government’s health care fraud enforcement efforts. The DOJ is devoting additional technology and human resources to targeting physicians, pharmacists, compound pharmacies, and other health care providers suspected of improperly prescribing, dispensing, and administering pharmaceutical medications. In 2017, Attorney General Jeff Sessions announced the formation of a new Opioid Fraud and Abuse Detection Unit, which is, focused specifically on opioid-related health care fraud using data to identify and prosecute individuals that are contributing to the opioid epidemic.

Similar to health care fraud, “prescription drug fraud” is a broad term that encompasses a wide range of civil and criminal offenses under numerous federal laws.

Practices that are frequently targeted by the Drug Enforcement Administration and other agencies include:

  • Refill schemes and drug “shorting”.
  • Dispensing more medication than was prescribed.
  • Illegally importing prescriptions.
  • Falsifying prescriptions.
  • Inaccurately reporting test results in order to prescribe drugs that are medically-unnecessary.
  • Selling fraudulent prescriptions.
  • Illegal drug compounding.

Compound pharmacies have also recently received renewed attention from federal law enforcement authorities. From allegations involving kickbacks and overfilling for compounded medication to falsified marketing of compound drugs as FDA approved, is a broad and highly targeted area under the umbrella of health care fraud.