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When is filling a compounded prescription Medicare fraud?

Florida and federal authorities are cracking down on the use of compounded prescriptions. As a result, some doctors, pharmacies and patients may find themselves accused of Medicare or Medicaid fraud.

Use of compounded prescriptions has spiked in recent years, and state and federal investigators are viewing the trend as an indication of fraud.

What are compounded prescriptions?

Compounded prescriptions are medications that are handmade by pharmacists, as opposed to medications that are commercially available. Examples of compounded medications are topical gels and creams formulated for a particular patient.

Compounded medications can cost from hundreds of dollars to more than one thousand dollars for a single prescription. Specially formulated medications may be medically necessary because the patient cannot take commercially available medications. However, when a commercially available medication can treat the patient's condition, prescribing and filling a compounded medication may be viewed as Medicare or Medicaid fraud.

What should I do if I am contacted by a state or federal investigator?

You have the right to remain silent and seek legal counsel. Now is a time when you should you use this right. Consequences of a fraud conviction include fines, prison, professional sanctions, and a lifetime criminal record.

The investigator may act like he or she is trying to help you clear up a misunderstanding. However, by attempting to explain the situation, you could give the officer information that is damaging to your case and could lead to your arrest.

Even if you are not prosecuted for fraud, you could be charged with a crime and sent to federal prison for "knowingly and willfully" making false or fraudulent statements to a federal officer, or for concealing information.

The best way to minimize the consequences is to remain silent and put your case in the hands of an experienced defense lawyer as soon as possible.

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