Our Fall 2023 Semiannual Report to Congress outlines the Department of Labor’s (DOL) workers’ compensation program and the unique challenges it presents to the Postal Service. Those challenges compound when healthcare providers exploit the program, just like the following case that happened in Houston, Texas.
Our OIG Hotline received a tip about suspected healthcare provider fraud involving an anesthesiologist and a pharmacy in the Houston area that produced compounded medications — that is, two or more ingredients mixed to create a custom medication. Our special agents collaborated with the DOL OIG, which was also working the case along with federal prosecutors.
Investigators found that under the direction of its owner, the pharmacy was producing and distributing compounding creams, gels, and pain patches that were neither medically necessary nor medically beneficial to patients. Investigators also found the doctor was writing bogus prescriptions for his patients, often without their consent. Over 90 percent of those claims involved patients who worked for the Postal Service.
To show how well-oiled the operation was, our agents interviewed patients affected by the scheme, finding both gross overprescription and excessive billing. In one instance, a patient who had received almost $100,000 worth of prescriptions through the mail said she received so many parcels containing various pain treatments that she asked the pharmacy to stop sending them