Two Million Chances to Say No


Say you want to generate about $13 Million in revenue one year by prescribing and selling over two million doses of oxycodone. That sounds terribly difficult, and I can’t imagine how someone would go about doing that.

Evidently it wasn’t terribly difficult for one drug salesman. According to a press release just issued by the Department of Justice announcing a guilty plea, here’s how he did it:

  1. The drug salesman opened up six pain clinics and two pharmacies;

  2. He convinced the drug wholesalers that he would serve as the compliance “inspector” who would ensure best prescribing practices;

  3. He convinced his pain clinics’ doctors that he was the perfect broker middleman to assist with pharmaceutical dispensing;

  4. He helped the pain clinics’ staff to complete site survey questionnaires that the manufacturers would use as proof of compliance to industry standards;

  5. He lied and misrepresented on the surveys;

  6. He ordered plenty of prescription pads!

Talk about the fox guarding the hen house.

Did any payor ever question the extent and duration of claimants’ scripts? Did any effective pharmaceutical review ever take place?

Apparently no one except law enforcement wanted to do better. For some drugs, appropriate utilization review and case management starts with the first prescription.

Call us. We can do better.

William Faris, JD
Chief Executive Officer

Posted in Medical Cost Containment, OMCA