Prescription drug fraud occurs anytime someone gets a prescription he or she does not need for medical reasons through negligent or unscrupulous ways. One of the reasons why such fraud is so important to stop is because it has played a large role in the expansion and severity of the opioid epidemic and could potentially lead to further situations.
Blue Cross Blue Shield explains that while prescription fraud occurs all across the country, almost half of the cases happen in the southern U.S. It is often the reason why so many people become addicted to controlled substances, and it can happen in a variety of ways.
Since doctors are the only individuals who can write prescriptions legally, most people looking to commit fraud will attempt to manipulate or trick doctors into writing them prescriptions. They may deceive the doctor, claiming symptoms they do not have, or they may see multiple doctors for the same issue, collecting multiple prescriptions for the same medication.
If doctors are not a part of a system that lets them check the complete history of a patient, they would never know that person saw another doctor for the same issue. So, this allows individuals to override the typical limitations on prescribing controlled medications.
For example, the law may limit the doctor to prescribing only one week’s worth of medication, but if you go to see three doctors and receive that same prescription, you will end up with three week’s worth of medication. If the doctors were all part of the same system, they would see that you had already received the maximum prescription.
Some people will bypass the doctor and forge their own prescriptions. While there are many safeguards in place to prevent this, some forgeries still slip through.
Another issue is doctors who write bad prescriptions. They may ignore rules or be part of the scheme that is committing the fraud.