Pharmacist must repay Medicaid $1 million
http://drugtopics.modernmedicine.com/drug-topics/news/pharmacist-must-repay-medicaid-1-million
From the article:
William Burdine, 65, owner of the Alvarado Medical Plaza Pharmacy in San Diego, was also sentenced to eight months of home confinement, 240 hours of community service, five years of probation, and a $10,000 fine.
Over the last 5-10 years.. I remember seeing a number of large fines for some of the major names in pharmacy Omnicare, Walgreen, CVS paying multi-million dollar fines for alleged Medicare/Medicaid fraud and abuse… There may be some legal nuance to how these charges were settled…but as I remember…
Whoever concocted the idea to defraud Medicare/Medicaid… did not go to jail or put under house arrest.. or personally fined.. or required to do community service
Whoever approved the idea to defraud Medicare/Medicaid… did not go to jail or put under house arrest.. or personally fined.. or required to do community service
Whoever implemented the idea to defraud Medicare/Medicaid… did no got to jail or put under house arrest.. or personally fined.. or required to do community service
the major difference seems to be that when you are a major publicly traded companies.. no one within the corporation is held personally liable for the actions of the corporation
If you are a small business.. a different set of game rules would seem to be applied..
Maybe this is a spin off of the bureaucratic concept of TOO BIG TO FAIL…. TOO SMALL TO MATTER
Filed under: General Problems
I agree.
My main concern is focused on health care for the mentally ill in the State of Indiana. I work in a pharmacy associated with Medicaid-resourced program. It is great that this program provides the whole shebang that is, it has a hospital care, out-patient care, a team approach (somewhat) with social work, and medication access application programs for those on Medicaid, and a retail pharmacy associated with medication access programs from manufacturers. BUT, a patient cannot use the program if they have private insurance–only Medicaid. They cannot see the program psychiatrist, because the MD is paid by Medicaid. They cannot see their own psychotherapists outside of the program, if they have private insurance. What happens to the patient in the interim between private insurance and Medicaid, and Medicaid and whatever? What happens to the patient when they lose Medicaid and have to pay out of pocket more than $1,500 for the monthly medication that keeps them sane? What happens when a patient cannot afford to take the medication, and becomes non-compliant and devolves back to baseline severe mental illness? The main, the major issue with mental illness is adherence to therapy. What happens when the access to therapy is inconsistent? What happens when a privately insured patient has no access to a whole support program such as what is offered by some of the Medicaid-funded mental health care programs? The patient is ‘thrown’ to the wolves’ on discharge from the privately funded hospital visit without a network of support and where do they go next?