Working as a pharmacist is a very demanding career. Many pharmacists put in far more than 40 hours per week. They have to complete multiple years of mandatory education before they can obtain a license and a job. They then usually need to oversee multiple subordinates and commit a lot of time and energy to their careers.
Despite their hard work, the pharmacy that employs them may struggle to generate enough revenue to effectively compensate everyone on staff and cover all operating costs. Financial concerns can be particularly stressful when the company is a small, privately-owned pharmacy.
Sometimes, pharmacists and their support employees use creative tactics to increase company revenue. Phantom prescriptions have been on the rise in recent years, and they are a form of fraud. Although this may seem like a victimless crime, a pharmacist could be at risk of prosecution and the loss of their professional license after a conviction or guilty plea.
What is a phantom prescription?
The term phantom prescription refers to a scenario where a pharmacy bills an insurance company for medication that the business does not deliver to a patient. There have been scenarios in which single patients have found thousands of dollars of extra charges in their Medicare billing history, for example.
Phantom prescriptions might involve situations where medical professionals send over a prescription but a patient never comes to pick it up. The pharmacy may bill for the prescription and act as though the patient did collect the medication. Other times, the phantom billing might involve medications and supplies that the patient in question does not even use.
Pharmaceutical professionals can use billing information from previous prescriptions to charge for medication not actually provided to a patient. Frequently, phantom prescription schemes target those on Medicare, as older adults may not review their invoices carefully.
However, such scenarios are particularly dangerous for pharmaceutical professionals. They could be at risk of federal prosecution because of the allegations involving fraudulent billing of government insurance programs. Even in scenarios involving private insurance, prosecution could be possible.
Fighting back against claims of pharmaceutical billing fraud can potentially help a professional to avoid criminal penalties and protect their license. Those convicted don’t just face incarceration and financial consequences but possibly also career consequences that could force them to change professions.
