CFI and Pharmacy Services Fighting Fraud


| 2 min read

If a pharmacy called you up to discuss a medication you needed, you’d probably assume it was legitimate. But unfortunately, that isn’t always the case. And in those situations, it helps to have Blue Cross Blue Shield of Michigan on your side. Recently, some Blue Cross members received phone calls from pharmacies offering them lidocaine (a prescription pain cream). The catch: The cost of the drug was thousands of dollars (compared to similar over-the-counter creams that cost significantly less). And once someone purchased the cream, they were immediately placed on an auto-renew plan that was difficult to get out of. As a result, they were billed over and over and over again. On top of that, these creams can cause serious side effects in some patients, meaning there was a safety issue with people purchasing them over the phone without talking to their doctors first. When members alerted Blue Cross about what was going on, the Corporate and Financial Investigations Unit and Pharmacy Services launched an investigation. They discovered that 15 pharmacies, located outside of Michigan, were inappropriately issuing Blue Cross members this pain cream over the phone. Those pharmacies were quickly removed from the extended pharmacy network. This abuse trend—called robo-call solicitation scams—is an increasing problem. That’s why Blue Cross takes fighting abuse and fraud seriously. Blue Cross does everything it can to discover inappropriate situations quickly and remedy them—something that protects your safety and helps you manage your health care costs. If you suspect you’re receiving a fraudulent offer, hang up immediately and report it by calling the anti-fraud hotline at 1-800-482-3787 or using this online form. For more on how Blue Cross fights fraud, see these other blogs:
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association