Pharmacy settles prior authorization fraud allegations

A New York-based speciality pharmacy has agreed to pay $115,000 to settle allegations it committed prior authorization fraud.  

The U.S. Justice Department accused DJ Drugs & Surgicals of submitting altered patient medical records to Medicaid in order to obtain insurance coverage for an expensive class of cholesterol-lowering medications. 

The pharmacy admitted that on at least 28 occasions between June 2017 and October 2018 it removed information from supporting documentation without the prescribing physician's authorization, according to a July 26 Justice Department news release. 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars

>