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Thread: Prescription fraud

  1. #1
    sad4sis is offline Junior Member
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    Prescription fraud

    What is the name of your state? PA
    My niece's boyfriend has pretended to be a doctor and called in a prescription for painkillers (I don't know which ones -- but they're supposed to be highly addictive) 11 times. This has been going on since September. He did this using someone else's insurance and signed for the prescription using a made up name. I have been trying to find info about possible penalties and fines and who exactly should be filing charges against him. We've been told that this is a felony, but what class? It is really difficult to find information about this. Thank you.What is the name of your state?
  2. #2
    RiotAct is offline Member
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    I'd have to wonder if they're not pulling your leg and telling you tales.

    Under normal circumstances, a doctor doesn't phone in prescriptions. One of the doctor's nurses or medical assistants do that.
  3. #3
    sad4sis is offline Junior Member
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    script fraud

    No -- they're not telling tales. Maybe the pharmacist said the call came from the doctor's office (I didn't talk to him, my sister did) and that's how the story was related. Nevertheless, he has been calling in scripts for himself, using someone else's insurance info (my sister's), and picking up the pills signing another name. He has been positively identified by my sister using the pharmacy's camera.
  4. #4
    CourtClerk is offline Senior Member
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    Prescription fraud, especially when there is a controlled substance involved can be a Federal Offense. Contact the US Attorney's office.
  5. #5
    sad4sis is offline Junior Member
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    a few more questions

    Who files charges in this kind of case...the doctor? the pharmacist? my sister? All three? A nurse told me that the pharmacist is obligated to report the fraud, but to whom? The doctor or the police? Then she said that it also depended on how aggressive the doctor was about these things -- some don't feel like getting into all the paperwork and some go ballistic. This seems like it's not cut and dried. I've read everything I could find on the internet about this (mostly just out of curiosity) and I have not really been able to find anything specific. Just one more question: Being my sister knows about this guy doing this, does she need a lawyer? Thanks for your info.
  6. #6
    ajkroy is offline Member
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    This is weird. Something doesn't add up. Controlled substances require a DEA number on the prescription and usually a hard copy sent to the pharmacy. Is he calling in scripts impersonating a real doctor? And how is he picking up without photo ID? I need ID now just to pick up cold medicine.

    If he is sophisticated enough to fake prescriptions, I would be very surprised to hear that he is using someone's insurance to pay for it. That is a sure-fire way to be caught. Every Rx fraud I ever heard of was paid with cash.

    Good luck.
  7. #7
    sad4sis is offline Junior Member
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    getting caught

    aj -- you're right, that's how he got caught, using my sister's insurance. The pharmacist, who was in a town about 30 miles away from where my sister lives, called my sister about the script -- I guess he finally got suspicious. I wonder what the heck took him so long. And how incredibly stupid to use the insurance card.
  8. #8
    sad4sis is offline Junior Member
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    adding it up

    aj -- you were very right, things just didn't add up about the script being filled. I'll leave it to you to figure out why the scripts got filled and sold without id. Thanks for your time.
  9. #9
    lealea1005 is offline Senior Member
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    Quote Originally Posted by sad4sis View Post
    Who files charges in this kind of case...the doctor? the pharmacist? my sister? All three? A nurse told me that the pharmacist is obligated to report the fraud, but to whom? The doctor or the police? Then she said that it also depended on how aggressive the doctor was about these things -- some don't feel like getting into all the paperwork and some go ballistic. This seems like it's not cut and dried. I've read everything I could find on the internet about this (mostly just out of curiosity) and I have not really been able to find anything specific. Just one more question: Being my sister knows about this guy doing this, does she need a lawyer? Thanks for your info.
    Not all narcotics require a hard copy Rx. Some can be called in with verification of the Physician's DEA#. A savvy drug seeker knows which ones can fly under the radar. Once the drug seeker slips up (and they always do) and the Pharmacist becomes suspicious, he/she will first contact the prescribing Physician to verify the validity of the Rx. If the Physician states that they did not write or call in the Rx, the Pharmacist then calls the police. Once the crime is reported to the police, and an investigation is initiated, it is out of the hands of both the Pharmacist and the Physician. State or Federal charges will be brought against the criminal. Physicians are protective of their DEA#'s and don't take kindly to drug seekers who steal their DEA#s to obtain narcotics. The Physician will be subpeonaed to testify.

    He could be charged (one charge for each prescription he obtained/called in) with forgery, obtaining a prescription by impersonation, obtaining a prescription by fraud, and/or manufacturing a prescription. I'm sure there may be other charges he'd be eligible for.

    If your neice was aware that her boyfriend was obtaining narcotics using her mother's insurance information, I suggest she also get an attorney. He's sure to throw her under the bus.
    Last edited by lealea1005; 12-28-2007 at 11:43 AM. Reason: spelling
  10. #10
    sad4sis is offline Junior Member
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    script fraud

    The Rx has called the police and we'll see what happens next. Turns out to be a second offense with schedule 3 drugs and he's also distributing. The BF has moved to a neighboring state but works in PA where it happened. I went on the DEA site and found a lot of info. Lea, thanks for your response.
  11. #11
    sad4sis is offline Junior Member
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    update

    The update is that there still has been no arrest -- this is unreal. This has been going on since before Christmas. There have been more crimes reported and still nothing -- no wonder there is so much fraud and crime, it seems so easy to get away with it! I don't understand this at all.
  12. #12
    sad4sis is offline Junior Member
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    update -- two months later

    i'm mostly writing this because there have been so many views to this post, so maybe someone will find this interesting. This is an update since just before Christmas 2007. Still nothing has been done ... police are making excuses for not arresting this jerk because he's so hard to find -- yeah, he works in an office 9 - 5, 5 days a week.

    The known crimes committed:
    11 counts of prescription fraud of hydrocodone
    11 counts of id theft
    a host of other things that I won't bother to add ...

    Come to find out this is a third offense. Good job.
  13. #13
    RiotAct is offline Member
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    Sort of makes you wonder if he's not one of their narcs.
  14. #14
    CdwJava is offline Senior Member
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    If I had to guess, I'd say they are working him ... not necessarily as a snitch, but using him as the bait to see who else might fall into the snare. These investigations CAN take months ... especially if it goes bigger than just one guy calling in phony prescriptions.

    Plus, what people KNOW and what the state can PROVE are different issues. The state must PROVE he is unlawfully attempting to obtain prescriptions and/or has committed fraud. From here, there is no way to gauge how good the evidence might be. So, the police might just be biding their time trying to get something more.

    Oh, and they certainly are not going to tell anyone outside law enforcement where the case stands.

    - Carl
    A Nor Cal Cop Sergeant

    "Make mine a double mocha ...
    And a croissant!"

    Seek justice,
    Love mercy,
    Walk humbly with your God

    -- Courageous, by Casting Crowns ... http://www.youtube.com/watch?v=pkM-gDcmJeM
  15. #15
    sad4sis is offline Junior Member
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    scripts w/ pix

    Hi -- thanks for your reply. One of the things that we've thought of is that they're going for the assistant pharmacist too because he probably had a lot to do with it. Outside of that, we have positive identification with pictures (store photos) and signatures on the pickup sheet.

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