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. 

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