Blue Cross warns of telemarketing prescription scheme

bcbsm

| 3 min read

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

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63 Comments

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Blues Perspectives

Mar 30, 2022 at 3:53pm

Hi Kane. It’s always best to hang up if you feel uncertain about the call. We encourage you to review the information on the following website on recognizing and reporting health care fraud. https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/how-to-recognize-and-report-health-care-fraud.html

K
Kane

Mar 29, 2022 at 9:41pm

I received a phone call today that asked some basic information, and the individual stated that they would send me a text message to review, which took me to attform.com to approve a medication order approved by a telemed physician. I never spoke with a physician... The conditions discussed were Pain and Migraines, yet Dermatology was also listed. For prescriptions for my pain, controlled substances are required as I can't take fast acting medication due to heart related conditions. And the heart medications discussed were not listed. They website (app.ezscriptrx.com) stated that my insurance would be billed and that everything would go through Carepoint pharmacey. There were two digital signature areas to be completed as well... I'm not sure if this was a scam or not, but I err'ed on the safe side... I'll continue to deal with my PCP and keep trying to get into pain management. This seemed too good to be true... The text came from phone # 855-529-6807 (Toll Free) and the originating phone call came from 469-907-0382 (Fort Worth,TX)

B
Blues Perspectives

Nov 30, 2021 at 9:19pm

Hi Elaine! We’re sorry to hear this is happening. You can report fraudulent calls here: https://www.bcbsm.com/health-care-fraud/index.html

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Elaine

Oct 6, 2021 at 4:37pm

How do I stop the phone calls? Should I just block them? Specialty Pharmacy has my name and number. I did not give it to them. They want me to authorize special injections sent to my md. I called to report fraud and that was a mistake they want all of my information that I would not give them. How do I report them This is the number that they give 855-427-4682

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Blues Perspectives

Jun 4, 2021 at 5:50pm

Hi Tresa! We’re sorry to hear this is happening. You can report fraudulent calls here: https://www.bcbsm.com/health-care-fraud/index.html

MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association