http://www.paidtwice.com/2008/04/03/a-tale-of-two-doctors/#comment-21677 Catherine Shaffer Sat, 05 Apr 2008 02:26:46 +0000 http://www.paidtwice.com/2008/04/03/a-tale-of-two-doctors/#comment-21677 That's insurance fraud. Call your insurance company and also your state attorney general and/or your state insurance regulatory agency. Some insurance companies fall under a different federal agency, but start with your atty general. It feels like a pointless drop in the bucket, but let me tell you a story. A couple years ago, my mother was very ill and needed nursing home care. When she was transferred from the hospital, an expensive, nonformulary medication that she had brought in from home was "disappeared" by the nursing home pharmacy. Turns out it was sent "back" to a mail order pharmacy when she was briefly hospitalized. The same thing happened twice, and each missing prescription was about $3000. It didn't cost us a dime out of pocket, because the missing medicin was replaced, and when I called the insurance company, their response was lukewarm. However, not six months later, there was a big news story about how that same mail order pharmacy was busted for insurance fraud. I am pretty sure they were taking back returned meds and reselling them. Probably also overbilling medicaid and other stuff. My mother's missing meds were an accident, because that pharmacy would never have dispensed that particular medication. But because of this, we were able to blow the whistle. I'll never know if our report made any difference, but I like to think we struck a blow for the little guy that day. Your $220 may not seem like much, but if they have taken a similar amount from just $1000 patients...well, that's one very nice boat that somebody has bought. And it's also a serious crime. That’s insurance fraud. Call your insurance company and also your state attorney general and/or your state insurance regulatory agency. Some insurance companies fall under a different federal agency, but start with your atty general. It feels like a pointless drop in the bucket, but let me tell you a story. A couple years ago, my mother was very ill and needed nursing home care. When she was transferred from the hospital, an expensive, nonformulary medication that she had brought in from home was “disappeared” by the nursing home pharmacy. Turns out it was sent “back” to a mail order pharmacy when she was briefly hospitalized. The same thing happened twice, and each missing prescription was about $3000. It didn’t cost us a dime out of pocket, because the missing medicin was replaced, and when I called the insurance company, their response was lukewarm. However, not six months later, there was a big news story about how that same mail order pharmacy was busted for insurance fraud. I am pretty sure they were taking back returned meds and reselling them. Probably also overbilling medicaid and other stuff. My mother’s missing meds were an accident, because that pharmacy would never have dispensed that particular medication. But because of this, we were able to blow the whistle. I’ll never know if our report made any difference, but I like to think we struck a blow for the little guy that day. Your $220 may not seem like much, but if they have taken a similar amount from just $1000 patients…well, that’s one very nice boat that somebody has bought. And it’s also a serious crime.

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