As part of the government’s efforts to reduce fraudulent behavior, it offers financial compensation to people who report certain types of fraud. These individuals, also known as “whistleblowers,” are an important source of information for the government, which is why it rewards them a portion of the proceeds it recovers in fraud cases. One type of fraud for which the government offers financial incentives to whistleblowers is pharmaceutical fraud. Pharmaceutical fraud is a term that encompasses a wide range of fraudulent behaviors. Below is an overview of the most common types of pharmaceutical fraud. If you have information that an individual or entity has engaged in any of the following practices, please contact a pharmaceutical fraud whistleblower attorney as soon as possible for assistance.
Common Types of Pharmaceutical Fraud
Automatic refill fraud
Most pharmacies automatically refill patient prescriptions. When a patient stops using a specific medication, the pharmacy isn’t always notified in timely manner. This sometimes results in the pharmacy refilling an unnecessary medication. Pharmacies sometimes take advantage of this by charging Medicare for the cost of the unneeded medication and selling it to make a profit.
All drugs in the U.S. must be approved by the FDA before companies can market and sell them. In addition, drug companies may only market drugs for the specific uses approved by the FDA. A medication’s FDA-approved use is known as its “label.” Doctors, however, are permitted to prescribe medications for off-label uses. Pharmaceutical companies commit pharmaceutical fraud when they market drugs to doctors for off-label uses.
Drug switching occurs when a pharmacy fills a prescription with a drug other than the one prescribed. Pharmacies profit from this illegal practice by filling a patient’s prescription with a cheaper medication than the one prescribed and submitting a claim to Medicare for the price of the more expensive medication.
Kickbacks involve payments or other rewards given to pharmacists by pharmaceutical companies in exchange for filling prescriptions with specific brands of drugs. This is essentially a form of quid pro quo, which is a favor granted or expected in return for something. Kickbacks are also sometimes combined with other types of fraud. For example, a pharmacy committing drug switching fraud may offer kickbacks to patients in order to persuade them to keep accepting the switched drugs.
If you have evidence of pharmaceutical fraud, contact our pharmaceutical fraud whistleblower attorney
If you have evidence that a provider or entity has committed pharmaceutical fraud, you may be entitled to a monetary reward. Before reporting, however, you should first consult with an experienced pharmaceutical fraud whistleblower attorney. At Newman & Shapiro, we have extensive experience handling pharmaceutical fraud cases, and we will be by your side every step of the reporting process, from filing your initial report to helping you collect your reward. Please contact us today for a consultation.