A Pennsylvania pharmacist was identified by the Independence Blue Cross (IBC) Corporate and Financial Investigations Department as engaging in illegal billing. In this scheme, the pharmacist would bill IBC for prescriptions for himself and family members that had not been prescribed by physicians. Numerous interviews of physicians and hospital administrative personnel during the investigation revealed a significant volume of false and fraudulent prescriptions that resulted in financial losses to IBC.
The facts of the case were referred to Montgomery County law enforcement authorities who undertook an investigation that culminated in the pharmacist’s arrest. The pharmacist eventually pled guilty to health care fraud charges. The pharmacist, who is awaiting court action, also made restitution to IBC in the amount of $86,070.88.