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The Wild West Of Compound Pain Medications

| Aug 19, 2019 | Firm News

Over the last several years, fraudsters have created a way to bilk TRICARE and other health insurers out of hundreds of millions of dollars.  These fraudsters have set up all inclusive fraud schemes in the area of compound pain creams, where they operate all levels of the scheme. They have a company which gathers lists of names and contact information of veterans or other vulnerable patients, they have a telemarketing company that calls the people on those lists, they have a company which has tele-docs at their disposal to issue the prescriptions, and they own the pharmacies which fill the prescriptions and bill TRICARE and others for the pain creams at a very inflated price.  The schemes work as follows: the telemarketing arm calls the patient and asks whether he or she has any pain; the patient says yes; telemarketer says they can supply the patient with a pain cream at no cost to the patient; they gather the patient’s insurance information and transfer the patient to a tele-doctor who writes a prescription; the doctor calls the prescription into the pharmacy and the pharmacy bills TRICARE or other health insurers- as much as $4,000 for a tube of cream!  TRICARE or other insurers pay the pharmacy, which splits the proceeds with the other companies involved in the scheme.  Some fraudsters have boasted raking in $13 Million a month through this scam.  All of this is at the taxpayer’s expense.  See the DOJ’s press release regarding Scott Rioux, a leader in this type of fraud.