Prescription Fraud

[TheHandGuy]

Sorry if this is in the wrong sub.
I recently hired a new medical assistant. My medical assistants have access to my DEA number as they typically print/send any prescriptions for my patients. I was recently contacted by a pharmacy and was asked if I had prescribed Xanax to a patient. They provided the patient’s name. I did not recognize them and I never prescribe Xanax, and it was for a pretty high dose and for 60 tablets. I told the pharmacist it was a fraudulent prescription. The pharmacist (who I thanked many times for catching this issue) asked for the person’s ID dropping off the prescription, and when told their name I recognized them as my new medical assistant. She apparently already had filled a prescription for 30 tablets at the same pharmacy (also using my DEA and forged signature) on a stolen physical prescription just a week prior. I’m assuming this is why the pharmacist flagged it and contacted me. After going through the proper HR channels, she has been fired and a police report has been filed by my practice. I was hoping for advice on what to do next. She admitted to taking a prescription pad home. I was going to file a separate report for her forging my signature and am going to contact the necessary people to change my DEA number. Is there anything else I am not thinking of? I want her to be punished to the full extent of the law and honestly I want to make an example out of her for the rest of the office (very large private practice group). I appreciate the help, thank you!

[southerndoc]

Rather than make an example of her, maybe she would benefit more from getting counseling about her substance abuse issues?

Just saying that it's better to help the individual rather than concentrate on prosecuting them where the underlying problem isn't addressed.

[Tim]

Sorry if this is in the wrong sub.
Is there anything else I am not thinking of? I want her to be punished to the full extent of the law and honestly I want to make an example out of her for the rest of the office (very large private practice group). I appreciate the help, thank you!

• Creating "examples" implies creating maximum damage and I question how much benefit for your office it would be.
• I would suggest reviewing how you ended up with a new employee that would do this. Background checks and drug screening come to mind. Surely something slipped through the cracks. Fixing THAT would benefit your practice.
• Do you have an EAP that allows confidential assistance for employees with any drug problem? Fixing THAT would benefit your practice.
• Are there any procedural changes that can be made of a preventive nature? Fixing THAT would benefit your practice.

I am suggesting not focusing on maximum damage on an ex employee, but rather risk management for your practice.

[Hatton]

I also had this happen about 10 years ago. The scripts were all hydrocodone containing cough syrup. Multiple pharmacies. When she started going to the same pharmacy daily I got a call. I called the nursing board (She was a LPN). DEA. She was arrested and sent to a drug court which means rehab.

[nephron]

That sucks. There are too many people out there that don’t belong in the work force. The problem is that then we end up paying for them one way another anyways.

[Anne]

Just want to point out that people who do this don’t necessarily have a drug problem themselves. Many are selling.

[Lordosis]

Beat me to it!

[Lordosis]

Any idea if she was using or selling?

That is really awful and it sucks to have that trust with your staff broken like that. It sounds like she is going to be in quite a bit of trouble anyways. I would not choose to go lenient but I do not think you have to make an effort to go hard. I would focus on your current staff and maybe call a meeting to explain the details as a way to avoid rumors. I think the others will catch the hint.

[afan]

I would not assume the employee was obtaining the drugs for her own use. Diverted prescription drugs are often sold rather than consumed by the person at the start of the chain. This is one major pipeline for opoids. If inalshe was getting the Xanax for sale, then the criminal would not have a drug problem and would have no need for therapy.

The ex employee committed serious crimes and exposed the practice, other employees and this particular physician to potentially ruinous penalties and criminal risk themselves. Full extent of the law is entirely appropriate. If the employee does need rehab, she can get that in prison.

As for what to do next, I would ask experts. The DEA sees all such cases that are exposed. They should know better than anyone how these things happen and what constitutes best practices to avoid a repeat. Your state medical society also should have resources on the subject. Your local or state police would see many of the cases but might not have expert advice on what docs can do to guard against being victimized. Cannot hurt to ask.

[G]

Sorry if this is in the wrong sub.
I recently hired a new medical assistant. My medical assistants have access to my DEA number as they typically print/send any prescriptions for my patients. I was recently contacted by a pharmacy and was asked if I had prescribed Xanax to a patient. They provided the patient’s name. I did not recognize them and I never prescribe Xanax, and it was for a pretty high dose and for 60 tablets. I told the pharmacist it was a fraudulent prescription. The pharmacist (who I thanked many times for catching this issue) asked for the person’s ID dropping off the prescription, and when told their name I recognized them as my new medical assistant. She apparently already had filled a prescription for 30 tablets at the same pharmacy (also using my DEA and forged signature) on a stolen physical prescription just a week prior. I’m assuming this is why the pharmacist flagged it and contacted me. After going through the proper HR channels, she has been fired and a police report has been filed by my practice. I was hoping for advice on what to do next. She admitted to taking a prescription pad home. I was going to file a separate report for her forging my signature and am going to contact the necessary people to change my DEA number. Is there anything else I am not thinking of? I want her to be punished to the full extent of the law and honestly I want to make an example out of her for the rest of the office (very large private practice group). I appreciate the help, thank you!

That stinks. I agree to ask the authorities what to do. State board of pharmacy and DEA in particular. This isn't their first rodeo.

We have had to deal with fraudulent rx a couple of times in our practice and also a co-resident back in the day. It is painful and requires a lot of uncompensated admin time of questionable benefit. You have my condolences, TheHandGuy .

[TheHandGuy]

Thanks to everyone for the replies. I have a hard time believing it was for personal use only when she obtained 30 tablets and within less than a week tried to get 60 more, unless she’s consuming 2mg Xanax tablets lIke they’re skittles. I didn’t mean to imply that I will do something like file a personal suit or anything like that, I just want to make sure she faces legal repercussions. Also, for what it’s worth, the pharmacist that contacted me originally ran a maps on her and found multiple Norco prescriptions filled by multiple physicians within the past few months, again leading me to believe (possibly incorrectly) that she was intending to sell more than use. Either way, as was previously mentioned by another user, she put my practice and my personal license at risk here which is why I am so upset.

Background check and drug screening were both performed by HR before hiring, and she cleared both.

Thanks again for all replies.

[SLC OB]

Did you get the rest of the Rx pad back? I'd make sure the police have that in their custody first!
She's new to your office, I'd contact past employers to see if they are missing Rx pads too... as this is likely NOT her first time doing this, especially so new to your office.
We had a office manager who embezzled from us... we live near a state line and he never came to court after discovering this. He was 'friends' with some office staff on FB and posted his new employer. My partner told the police and they were able to get a warrant, across state lines, to go arrest him at work. My partner then called the practice there to inform them of his embezzling. As he was arrested, he told the office staff it was outstanding parking tickets. People will continue to show their colors...

[TheHandGuy]

Did you get the rest of the Rx pad back? I'd make sure the police have that in their custody first!
She's new to your office, I'd contact past employers to see if they are missing Rx pads too... as this is likely NOT her first time doing this, especially so new to your office.
We had a office manager who embezzled from us... we live near a state line and he never came to court after discovering this. He was 'friends' with some office staff on FB and posted his new employer. My partner told the police and they were able to get a warrant, across state lines, to go arrest him at work. My partner then called the practice there to inform them of his embezzling. As he was arrested, he told the office staff it was outstanding parking tickets. People will continue to show their colors...

Yes we got the prescription pad, but I will admit our office does not track prescriptions as well as it should (not numbered) so there’s no telling how many scripts she kept before returning whatever was left of the pad. I think this will be an eye opener for the entire practice and will hopefully lead to better handling of prescriptions by everyone.

[Lordosis]

I can count on one hand how many prescriptions I actually wrote this past year. Don't you use electronic prescribing? Why are prescription pads so readily available?

Also to your comment above you would be surprised at how much benzodiazepines and or opiates people can consume. Something that might kill URI who are naive to them it's just a small taste for somebody who has become tolerant. Some 30 tablets does not seem all that excessive for a week's use. Even still I think it is more likely diversion based on the information you provided us.

[StateOfMyHead]

Sorry you have to deal with this. If you haven't I would notify whatever board MAs are licensed under in your state. Unless you know a previous employer I don't think I would contact them as it might come back to bite you. Like if she is found not guilty or whatever and later claims you damaged her reputation?

[Tim]

One thing of note is to make sure that the law enforcement is aware of your desire to prosecute even to the point when it goes to the DA. A prosecutor with a party that wants appropriate charges pressed is less likely to cop a minor plea bargain to simply close the case on a "victimless crime". "Let me know when I need to testify" is a rather clear message. You expect a prosecution. In your case, it's not only the drugs, your license and practice was jeopardized.