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Pharmacy Fraud, Past Present and Future

By Robert David, Esq.

Many in the healthcare industry and the attorneys who represent them in South Florida notice trends in law enforcement and criminal prosecutions that are logically preceded by increased audit activity. There are generally surges in prosecutions following increased outlays in Medicare and Medicaid spending on services, claims or equipment. Recently, the federal government has dedicated substantial resources, particularly in South Florida , to the prosecutions of physicians and clinic owners alleged to be engaged in fraud related to the administration of HIV medications; these were preceded by increased audits and overpayment demands with regard to most of the physicians and clinics later prosecuted. With the 2006 amendments to Medicare and the creation of Part D, there was a tremendous surge in prescription drug spending by the Medicare Program, however the audit activity did not really catch up with the increased spending until recently...continue to full post

Full post as published by Health Care Fraud Blog on April 08, 2009 (boomark / email).