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Medicare


UNDERCOVER VIDEO SHOWS HOW PRESCRIPTION DRUGS ARE ADULTERATED AND MISBRANDED IN
THE BLACK MARKET


SOUTH FLORIDA HAS BECOME THE EPICENTER OF MEDICARE FRAUD, ACCORDING TO THE
DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE CRIME, THEY SAY, NOT ONLY COSTS
TAXPAYERS BILLIONS OF DOLLARS, BUT OFTEN PUTS PATIENTS' LIVES IN DANGER.

BY MYRIAM MASIHY • PUBLISHED MAY 18, 2024 • UPDATED ON MAY 18, 2024 AT 11:17 AM


NBC Universal, Inc.

Video taken by an undercover government informant shows a woman, her son and
husband wiping labels off prescription medication bottles in a South Florida
apartment. They use lighter fluid to remove the labels, then reattach the
Information packet to the bottles that contain expensive medication including
HIV meds that patients chose to sell.

Fernando Porras, assistant special agent in charge with the U.S. Department of
Health and Human Services’, Office of Inspector General (HHS OIG) says the
practice of skipping your HIV meds to sell them is dangerous.  “Their viral
levels could increase, and they could potentially infect a partner or the
population…And for patients that consume medications that were stored under
perhaps not the best of conditions, it may affect the quality of the
medication,” says Porras.

24/7 South Florida news stream: Watch NBC6 free wherever you are

HHS OIG says drug diversion is just one of the ways criminals steal billions of
dollars from Medicare each year. “Unfortunately South Florida is the epicenter
of Medicare fraud,” states Porras.

Drug Diversion Works like this:  A patient picks up a prescription valued at
thousands of dollars and sells it to an aggregator for a fraction of the price.
The buyer, known as an aggregator, removes the label and sells it to a
wholesaler who then sells it back to a pharmacy at a discount. “A pharmacy could
easily bill the Medicare program two and three million dollars doing this
scheme,” Porras says.

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The family from the video was found guilty and served 2-to-3-year prison
sentences for Defrauding the United States and Engaging in the Unlicensed
Distribution of Prescription Drugs.

In another case, Lázaro Hernández pleaded guilty to running an elaborate scheme
to distribute more than $230 million dollars’ worth of adulterated and
misbranded prescription drugs and sentenced to 15 years behind bars. “Weoften
hear about providers, owners of clinics or medical facilities being arrested or
indicted. And unfortunately, we've arrested a lot of doctors as well…but it's
not uncommon for us to arrest beneficiaries as well for being on the take,” says
Porras.

HHS OIG stresses it’s important to be on the lookout for these types of
schemes.  The fraud usually happens when someone bills Medicare for unnecessary
equipment, treatments, or prescription drugs.  It can also happen when someone
offers to pay a Medicare beneficiary to enroll in a program or treatment they
don’t need or calls them claiming they are from Medicare and want to send them a
free genetic test.


INVESTIGATIONS

The NBC 6 Investigators get results

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SPRINGS

To combat Medicare fraud, HHS OIG asks beneficiaries to be thorough. “We ask
them to review their explanation of benefits, although it says it's not a bill,
it potentially could indicate whether there's fraudulent activity in their
account,” Porras explains. He says if you see fraudulent activity, you should
report it to Medicare immediately and if you’re having a hard time reading that
document, you can ask it be sent in your language or in bigger font. 

Read More

THIS ARTICLE TAGGED UNDER:

Medicare



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