Resources & Information

The NC Board of Pharmacy took action last year against five NC pharmacies involved in a national scam that resulted in unnecessary billing for diabetic pain creams and other products not prescribed by the patients’ medical providers. Physicians and PAs are advised to be wary of faxed requests seeking authorization for any treatments they have not personally recommended for their patients.

The pharmacy scam targeted patients with diabetes, often with advertisements promoting free or low cost diabetic testing supplies. According to NCBOP, patients who responded to these ads, spoke by telephone with unlicensed, non-medically trained sales representatives who pitched additional products, such as non-narcotic topical pain treatments including lidocaine ointment and diclofenac sodium gel.

After patients provide billing and insurance information, prescription orders are then faxed to the patients’ medical providers for signatures. Orders indicate that the patient has “requested” the items listed, prompting unsuspecting prescribers to authorize prescriptions and other items not prescribed by a licensed medical professional. This results in billing for items that may be unnecessary and unwanted by the patient. In some instances, patients never received items ordered on their behalf, according to NCBOP.

Bottom line: Be careful about automatically authorizing any order for medicine or medical supplies that you did not prescribe or recommend.