pharmacist

All posts tagged pharmacist

Health Care Fraud Enforcement Continues to Rock Pharmacy Industry

by admin on April 30, 2021 No comments

pharmacy fraudBy: Karen Davila

Yet again, the fraud enforcement arm of the DOJ strikes out against fraud in the pharmacy industry.  Two new cases shed continuing light on the ongoing fraud.

Announced last week by the DOJ, the owner/operator of five pharmacies in New York pled guilty to charges stemming from a scheme to defraud Medicare and Medicaid by billing for prescription drugs that were not dispensed, not prescribed, not medically necessary or dispensed when the pharmacy had no authority to dispense the prescription drugs.  This blatant disregard for the law was magnified when the owner/operator used the ill-gotten gains of her scheme to purchase luxury items like cars and jewelry.  Nothing screams “come and get me” like openly flaunting the money taken from the government.

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adminHealth Care Fraud Enforcement Continues to Rock Pharmacy Industry

2021 Pharmacy Enforcement Actions in Full Swing

by admin on February 5, 2021 No comments

By: Michael Silverman

The new year has brought with it no lull in pharmacy fraud crackdowns and enforcement actions, with allegations related to over one billion dollars in false claims.

Here’s a breakdown of the latest:

Mississippi Man Sentenced to 18 Years in Prison and $287,659,569 in Restitution

This individual spearheaded a scheme involving kickbacks to marketers and prescribers to defraud TRICARE and other healthcare programs by submitting claims for unnecessary compounded medications, which also involved routine waiver of patient financial responsibility.

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admin2021 Pharmacy Enforcement Actions in Full Swing

Webinar | How to Protect Your Pharmacy from Risky Prescriptions

by admin on February 3, 2021 No comments

You process hundreds of prescriptions each week. You dispense controlled substances. How do you protect yourself from risky prescriptions? In this webinar with attorney Karen Davila, you will learn about the current enforcement environment and hear some strategies for mitigating the risks of filling a bad prescription. You’ll also get some simple tips and tools for developing a compliance program right-sized for your pharmacy.Webinar register here button

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adminWebinar | How to Protect Your Pharmacy from Risky Prescriptions

Pharmacists Authority To Give Vaccinations Expanded By HHS

by admin on August 26, 2020 No comments

pharmacists giving childhood vaccinesBy: Zach Simpson

On August 19, an amendment to the Public Readiness and Emergency Preparedness Act was announced by HHS which allows pharmacists in every state to now administer childhood vaccinations to children ages 3 and older, subject to several requirements,

  • The vaccine must be approved or licensed by the Food and Drug Administration (FDA).
  • The vaccination must be ordered and administered according to the CDC’s Advisory Committee on Immunization Practices (ACIP) immunization schedules.
  • The licensed pharmacist must complete a practical training program of at least 20 hours that is approved by the Accreditation Council for Pharmacy Education (ACPE). This training program must include hands-on injection technique, clinical evaluation of indications and contraindications of vaccines, and the recognition and treatment of emergency reactions to vaccines.
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Physician Dispensing as it Relates to Injured Workers Clarified by the Florida Workers’ Comp Division

by admin on June 30, 2020 No comments

physician dispensingBy: Zach Simpson

On March 31, 2020 the Florida Division of Workers’ Compensation (DWC) clarified that physicians are permitted to dispense medications to injured workers, and that an injured worker shall have full and free choice to utilize their physician for medication dispensing, as well as any other pharmacy or pharmacist.

It was declared by the DWC that it is not appropriate for employers/carriers to deny authorization or reimbursement for prescription medication solely because the medication is dispensed by the treating physician who is a licensed Florida dispensing practitioner instead of a pharmacist.

What Led to the DWC Bulletin?

A Florida dispensing practitioner was denied reimbursement for drugs dispensed out of their office to an injured worker in a recent reimbursement dispute claim. The physician asserted the claims administrator denied reimbursement for the dispensed medications because the physician was not authorized to dispense prescription medications. The Florida Department of Financial Services (DFS) ruled in favor of the physician – DFS Case No.: 20180824-007-WC – and subsequently issued DWC Bulletin DWC-01-2020 on March 31, 2020.

Details of the DWC Bulletin

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adminPhysician Dispensing as it Relates to Injured Workers Clarified by the Florida Workers’ Comp Division