Moxie, Money and Muscle

Evidently I was a little busy during the early 2000s, as I must have been one of the few people who never watched HBO’s The Sopranos. Thanks to Amazon Prime, I was able to binge my way through six seasons over the last couple of months. What I find fascinating is how Tony and his mob Capos were able to control and operate numerous ventures while never being listed as the actual owner/officer on any documents.

 

When you have moxie, money and muscle, there is no limit to your racketeering opportunities.

 

The Coalition Against Insurance Fraud recently reported on a Midwestern pharmacist who also liked to be a “behind the scenes” owner of a conglomerate that included numerous:

• Compound Pharmacies;
• Physicians;
• Nursing Homes;
• Long-Term Care Facilities.

 

This individual had plenty of moxie, as his mixology specialty was something he named “Speed Cream” which cost $40 to make and was invoiced to insurance companies for a cool $1,000. Anonymous control of these ventures smoothed the way from prescriber to dispenser to end user.

 

These fraudulent transactions went on for four years before the Feds shut them down.

 

Pharmacies are a crucial component of effective provider networks, and with the right oversight, it is possible to eliminate the rogue dispensers and compounders.

 

Maybe it’s time you, the payor, should get to use a little muscle with aggressive and knowledgeable oversight.

 

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

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