MeridianRx is committed to reducing pharmaceutical fraud, waste, and abuse (FWA). Our compliance program is designed to combat FWA, and we continuously develop new tools for detection and prevention.
There are many types of pharmaceutical fraud, waste, and abuse, including:
Inappropriate billing practices by pharmacies, such as billing for non-existent prescriptions or billing for brand name drugs when cheaper generic drugs are actually dispensed.
Illegal kickback schemes: A pharmacy or PBM is offered, paid, solicits, or receives unlawful payment to induce or reward the pharmacy or PBM to switch patients to different drugs.
Prescription mills: A physician writes prescriptions that are not medically necessary, often in mass quantities, and often for patients that are no theirs. These prescriptions are generally written for controlled drugs to sell on the black market. These might also include improper payments to the provider.
Physicians providing false information that is not consistent with the medical record to a health plan or PBM in order to justify coverage of a prescription requiring a prior authorization or satisfaction of another formulary oversight mechanism. Theft of a physician's DEA number or prescription pad.
Release or distribution of counterfeit or adulterated drugs onto the open market through black and gray market purchases by pharmaceutical wholesalers. Such counterfeit drugs include those that are fake, diluted, expired, or illegally imported. Illegal promotion of off-label usage of drugs by pharmaceutical manufacturers through marketing, financial incentives, or other promotion campaigns.
Forging or alteration of a prescription by a patient, pharmacist, or other person without prescriber approval in order to increase quantity or number of refills.
Patients obtaining drugs from a physician in order to give the prescription to a family member or illegally sell the prescription.
If you suspect that someone is committing pharmaceutical fraud, waste, or abuse, please contact MeridianRx. Your report may be made anonymously.
Attn: David Janis, Esq.
1 Campus Martius, Suite 750
Detroit, MI 48226