Healthcare provider fraud can take many forms, from submitting multiple claims for the same service to billing for services never rendered to billing for a more expensive service than patients actually received. The list goes on.
A recently closed provider fraud case was so extensive that it nearly stretches the imagination — not just in terms of scope but also in complexity. This case dates to December 2015, when USPS OIG investigators initiated a review of an unusually high level of Postal Service-related claims for compounded medications — that is, two or more ingredients mixed to create a medication tailored to patients’ needs. The claims had been filed with the Department of Labor (DOL) Office of Workers’ Compensation Program (OWCP) and showed a pharmacy as a disproportionately high biller, having received $4.2 million for compounding drugs that year.