Blue Cross warns of telemarketing prescription scheme

Blue Cross warns of telemarketing prescription scheme

When you think about the things in your life you want to protect, your mind probably goes to your home, family, and financial information. But now, more than ever, it’s also important for you to be vigilant in protecting your personal medical information.

Recently, Blue Cross Blue Shield of Michigan’s Corporate & Financial Investigations team fielded complaints from members who received unwanted medication, supplies and durable medical equipment (DME) mailed to them. Usually, receiving unexpected packages can either mean a belated birthday gift from Aunt Sally or an online shopping purchase you forgot you made. But imagine checking your doorstep to find a box full of blood glucose meters and diabetic testing supplies you did not request or are not medically necessary for you.

After an investigation, Blue Cross learned that some telemarketing companies were soliciting insurance information and primary care physician’s contact information directly from patients through phone calls, emails, social media and online or mail surveys. These companies then faxed fake prescriptions to the prescriber’s office to obtain authorization and place an order. Other times, pharmacies called requesting authorization from the prescriber to change a medication.

Once the authorization was received, the members unexpectedly began receiving mailed deliveries of medications or durable medical equipment supplies. The member would receive the order, and the cost of the unnecessary medication or equipment was paid by the member’s employer group coverage.

In 2018, Blue Cross identified numerous physicians and pharmacies involved in this scheme. Information was shared with other Blue Cross plans as well as law enforcement agencies to help raise awareness of the scam. Blue Cross also blocked several prescribers and pharmacies from being able to continue this scheme.

Avoid Being a Target

These high-cost scams could also lead to higher insurance costs for members. So, how can you protect yourself (and your wallet)? Start by following some basic tips:

  • Know the source. Be wary of any communication from a doctor or other entity (such as an online prescription service) who initiates contact with you. If you have a medical issue, you should visit your primary care physician or a referred specialist.
  • Keep it personal. Don’t give out personal or insurance information online. Unsolicited phone calls, surveys or emails asking for your insurance or doctor’s information should be a red flag.
  • Don’t be tempted by freebies. Be wary of anyone giving away free medication on social media or someone who offers a reward for filling a prescription. What looks free at first, may end up costing you and your employer more money in the longer run.

Members who have been caught up in this scheme reported difficulty getting the dispensing pharmacy to stop sending medications. Therefore, it’s important to learn how to avoid becoming involved in the onset.

For more information on prescription drugs, check out these additional blogs:

Photo credit: home thods

Leave a Comment

Your email address will not be published.

Read 63 Comments