From the Office of Inspector General (OIG), U.S. Department of
Health & Human Services
Prescription Drug Fraud
Beneficiaries have the option of the Part D prescription drug
benefit. This has been a wonderful advantage for seniors to help in
their medication needs. However, this has also opened the door for new
and unprecedented fraud attempts.
How the Scam Works
One area of concern in Part D fraud is prescription shorting. This
is where a fraudulent pharmacy routinely dispenses prescriptions a few
pills short. In a large prescription the pharmacist hopes the
beneficiary will not notice. If the pharmacist does this repeatedly, the
pharmacy can steal a lot of money from Medicare because Medicare is
billed for the full amount.
In a similar scheme, a fraudulent pharmacy may fill a partial
month’s drug supply and ask the beneficiary to come back for the
rest. The pharmacist then bills Medicare twice in one month for the full
A new prescription drug diversion tactic is to talk a beneficiary
into getting a prescription from his physician for a narcotic. It
is then filled and billed to Medicare. The beneficiary is then paid cash
for the script and the drugs are cycled back through the pharmacy or
sold on the street.
How to Fight Back
Although time-consuming, consider counting your pills when you first
get the prescription filled to make sure you were not shorted on the
Do not participate in prescription drug diversion fraud. It is
highly illegal and criminal behavior and can get the participating
beneficiary into severe legal trouble as well.