Fads can be described as a short-lived enthusiasm for something that emerges quickly then eventually fizzles out. Some examples include bell bottom jeans, go-go boots, Baby on Board signs, Rubik’s Cubes and Silly Bandz. In contrast, trends refer to a general direction that something is heading, all the while changing as it grows. For example, the portable music player trend has come a long way from Boom Boxes, Sony Walkmans and personal CD players to MP3 players and downloadable music via smart phones. An article published by the South Florida Business Journal tells about a different kind of fad growing within the trend of Medicare fraud.
According to the article, the new Medicare fraud fad is related to Medicare Part D, which happens to be the government’s prescription drug benefit program. (Apparently, the previous fad involved clinical billing. I guess that once the government caught onto the ruse, fraudsters moved on to Part D fraud.) According to a report by the inspector general of Health and Human Services,data shows that more than 1,400 pharmacies had questionable billing practices in 2014 related to the drug program, collectively billing Medicare Part D more than $2 billion last year alone.
The pharmacist in this particular case allegedly submitted false Medicare claims resulting in more than $1.5 million in illegally-obtained funds. The pharmacy owner and operator claimed that the prescription drugs, which were prescribed by a doctor for Medicare beneficiaries, were medically necessary. (In actuality, the pharmacist admitted to stealing or paying for beneficiary information that was used to submit the bogus claims.) As a result of her fraudulent claims, her pharmacy received millions of dollars from the government program. (The story says she used the ill-gotten funds for her own benefit.)
The 47-year-old pharmacist pleaded guilty to one count of health care fraud. According to the article, she was just one of 243 individuals across the nation indicted as part of the United States’ largest efforts to take down Medicare Part D fraud.
Medicare Part D is meant to subsidize the high costs of many prescription drugs and insurance premiums for Medicare beneficiaries, not provide extra pocket change for criminals to use as they wish. While Medicare Part D remains vulnerable to widespread fraud, the government is working hard to make sure this particular type of fraud fad dies a quick death and does not become a trend.
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