Transcript for audio podcast: Drug Diversion Overview
From the Office of Inspector General of Department of Health and Human Services
[Roberta Baskin] I'm Roberta Baskin, Director of Media Communications. And joining me is Jennifer Trussell, a Special Agent in Charge within our Office of Investigations. Jennifer, what exactly is drug diversion?
[Jennifer Trussell] Thanks, Roberta. You know, drug diversion, in its simplest form, is the redirection of prescription drugs for illegitimate purposes. It represents a serious public health issue, where drug abusers are dying daily from overdoses, and families are torn apart. It also financially drains our Medicare and Medicaid programs by taking money away from legitimate care.
[Roberta Baskin] How big of a problem has it become?
Prescription drug abuse is this nation's fastest growing drug problem and is reaching epidemic proportions. You know, prescription drug coverage under Medicare Part D costs more than $50 billion dollars per year. What we don't know is what portion of that spending goes to drug abuse and fraud instead of legitimate prescription drug needs.
[Roberta Baskin] We're hearing this is not just one kind of fraud. So who's involved in these schemes?
[Jennifer Trussell] Well there are definitely several categories of individuals who commit drug diversion, and each for different reasons. First, there are the drug-seeking patients who visit multiple healthcare providers and obtain medically unnecessary prescriptions. These patients often consume the drugs, sell them on the street for a profit, or both. Many drug-seekers are addicted to prescription pain killers and narcotics.
[Roberta Baskin] What about healthcare providers?
[Jennifer Trussell] Doctors, physician assistants, and nurse practitioners can be involved. In some cases, providers have written thousands of unlawful prescriptions which were billed to Medicare Part D. You know some medical offices are nothing more than pill mills, and provide no legitimate medical care. And of course some healthcare providers are addicted themselves.
[Roberta Baskin] What about drug traffickers?
[Jennifer Trussell] Well certainly another concerning category is the drug fraud trafficker. Many of these criminals have turned from illegal drug to prescription drug trafficking because it is more profitable. These criminals commit egregious fraud to include the theft of patient and provider identities, and often cause millions of dollars in fraudulent Medicare billing. They will play, with whoever will pay.
[Roberta Baskin] And what role do pharmacies play in drug diversion?
[Jennifer Trussell] A major one. We've investigated cases of fraudulent pharmacies using patients' Medicare numbers to bill for tens of thousands of dollars in unneeded prescriptions. In exchange, the pharmacy gives money or drugs to the patient. In some fraud schemes, pharmacies stock or re-label expired and counterfeit medications, and bill and sell them as legitimate prescriptions to unsuspecting patients.
[Roberta Baskin] What's a good example of that?
[Jennifer Trussell] One example is Dr. Stephen Schneider from Haysville, Kansas. Dr. Schneider and his wife ran a pill mill and wrote thousands of medically unnecessary narcotic prescriptions. Fifty-six of Dr. Schneider's "patients" died of accidental drug overdoses. He was directly linked to the deaths of four patients and he billed the drugs to Federal health programs and private insurers for over $4 million dollars. Both Dr. Schneider and his wife were sentenced to more than 30 years in prison.
[Roberta Baskin] That's an extraordinary case. Are there any new trends that seem to be making this problem even worse?
[Jennifer Trussell] Absolutely. We are seeing patients mix a narcotic with a muscle relaxant or sleep aid, and then add in a psychiatric medication. This produces a powerful but dangerous high, and it can cause death from respiratory arrest.
Another trend is counterfeit medication. Some of these counterfeit drugs are illegally imported in to the United States or ordered over the Internet. You know some are less potent or knock-offs of the real drug, but many contain nothing but dangerous ingredients straight off the shelf of a hardware store, such as compressed drywall dust coated in highway paint. Counterfeit medications pose a serious health hazard to our citizens and taxpayers often foot the bill.
[Roberta Baskin] So what do we do to combat the drug diversion problem?
[Jennifer Trussell] Well, approximately 47 States have monitoring programs that flag potentially fraudulent activity by patients and providers. A General Accounting Office report notes that these monitoring programs do help to reduce prescription drug diversion.
But what I want to stress, is that prosecution alone cannot solve this problem. The first step to fixing this problem is educating our communities, patients, and providers. Prescription drug diversion is a clear health danger to everyone, it's devastating local communities, and is often fraud committed against our Federal programs and the American taxpayer. The OIG is working diligently on this problem along with our partners in the Drug Enforcement Administration, FBI, Federal prosecutors, and local law enforcement. We need everyone's help.
[Roberta Baskin] We need everyone's help, and we're all paying for it. Thank you, Jennifer Trussell, for sharing these important insights on drug diversion.
[Jennifer Trussell] Thank you, Roberta.
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