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Pharmacy Fraud Lawyers

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What Is a Whistleblower?

A whistleblower is an employee who reports their employer for breaking a law. This information is typically reported to a government agency that is responsible for regulation, such as the FDA or the EPA. Some employees in the pharmacy industry have recently reported their employers for pharmacy fraud.

What Is Pharmacy Fraud?

Criminal fraud occurs when a person intends to deceive another by making false representation of a fact. The fact results in the other person relying upon the information to his legal detriment. Pharmacy fraud occurs when that false representation of a fact is made about a prescription. The other party relies on that false information about the prescription to their legal detriment. 

What Are Examples of Pharmacy Fraud?

Examples of pharmacy fraud schemes include:

  • Billing for a non-existent prescription
  • Prescription drug switching
  • Sending multiple bills to different payers for the same prescription
  • Billing for a brand name drug when a generic drug was given to the customers
  • Filling a less than the quantity prescribed in the prescription

What Is Prescription Switching?

Prescription switching involves substituting a particular drug for a more expensive prescription drug while still charging for the more expensive drug. The drug given may not be the generic form, but it costs less than the drug prescribed.

Is Medicaid or Medicare Fraud Associated with Pharmacy Fraud?

Yes. Fraud involving Medicaid or Medicare occurs when a company bills the government for health services or prescriptions that never happened. One example is auto-refilling pharmacy fraud. The scheme involves automatically refilling a prescription for a patient without authorization from the patient. The pharmacy will then bill the government for the filled prescription.

What Should I Do If I Am Accused of Pharmacy Fraud?

Pharmacy fraud is a serious crime. If you are accused of pharmacy fraud, you should contact a criminal lawyer. They can inform you of your rights in the situation and help you defend yourself, and your business, against pharmacy fraud charges.

Photo of page author Taelonnda Sewell

, LegalMatch Legal Writer

Last Modified: 06-27-2018 12:10 AM PDT

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