Meghan Sebaugh, CFE
Meghan Sebaugh, CFE, is compliance manager, Strategic Operations at EmpiRx Health, LLC, a pharmacy benefit manager. She is also on the board of directors for the ACFE Chapter in St. Lous, Missouri. Contact her at sebaugh.m@gmail.com.
Treating fraud in independent pharmacies
In 2020, the U.S. Department of Justice (DOJ), in its largest health care fraud enforcement action to date, indicted 345 various health care professionals for submitting $6 billion worth of fraudulent claims to federal programs and private insurers. Among those ensnared in the takedown were pharmacies, which were accused of scheming with telemedicine entities and other licensed health care providers to purchase unnecessary medical equipment and prescription pain medications in exchange for illegal kickbacks and bribes, as well as the illegal distribution of opioid drugs. (See “National Health Care Fraud and Opioid Takedown Results in Charges Against 345 Defendants Responsible for More than $6 Billion in Alleged Fraud Losses,” U.S. Department of Justice, press release, Sept. 30, 2020.)
Written By: Meghan Sebaugh, CFE
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