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What are the most common prescription fraud charges?
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Common Prescription Fraud Charges
Prescription fraud refers to illegally obtaining prescription drugs, usually by deceiving doctors into writing unnecessary prescriptions or altering legit prescriptions to get more drugs. It’s a pretty common crime that can lead to some serios charges. Let’s break down the most common prescription fraud crimes and penalties people face.
Forging or Altering Prescriptions
One of the most common types of prescription fraud is making fake prescriptions or changing real ones. This includes things like:
- Using a stolen prescription pad to write out fake prescriptions
- Changing the drug, dose, or number of refills on a real prescription
- Using someone else’s prescription without their consent
- Photoshoping or digitally editing a prescription
Penalties depend on the specific drugs and quantities involved, but can include both fines and jail time. Even small amounts of controlled substances like painkillers or ADHD drugs can lead to charges. And if you have a prior record or committ other crimes like identity theft as part of the fraud, you’ll face harsher punishments.
For example, this Virginia pharmacist got 2 years in prison for billing Medicare for $1 million in expensive compound creams he never actually bought or dispensed. And this Boston radiology tech faced multiple felony charges for his role in a scheme to get unneeded Adderall and testosterone prescriptions.
Doctor Shopping
“Doctor shopping” means going to multiple doctors to get multiple prescriptions for the same drugs. It’s illegal because it uses deception to stockpile medications, often for abuse or illegal resale. Penalties vary by state but may include both fines and imprisonment.
For instance, a patient who sees 5 differnt doctors in a month to get oxycodone would probably face charges for doctor shopping. Seeing multiple specialists for legit medical issues generally isn’t considered doctor shopping. The key is deceiving each doctor about what other physicians you’re seeing to hide how many scripts you’re getting.
Selling Prescription Drugs
It’s illegal to sell your legitimate prescription drugs to others. That includes things like:
- Selling your leftover pain pills to friends or on the street
- Giving or selling your ADHD meds to help others study
- Sharing your antibiotics with sick family members
Penalties vary widely from state to state but often include both fines and jail time, especially for drug dealers and trafficking operations. Even small amounts of controlled substances can lead to charges.
For example, this group of doctors and medical pros made $2.5 billion running telemedicine and pharmacy fraud schemes, including illegally prescribing and selling opioids. Many face decades in federal prison.
Prescription Theft
Stealing legit prescriptions is also illegal. This includes things like:
- Taking prescription pads or scripts from doctors’ offices
- Stealing filled prescription bottles from pharmacies or homes
- Accessing someone’s online pharmacy account without consent
Like other prescription fraud, penalties depend on the specific drugs and amounts involved. But expect fines and possible jail time even for small controlled substance amounts.
Insurance Fraud
Lying to insurance companies about medical conditions or treatment to get coverage for unnecessary drugs is prescription insurance fraud. This includes things like:
- Faking illnesses to get painkiller or ADHD prescriptions covered
- Hiding other insurance plans to get more coverage for a drug
- Lying about taking cheaper generics to get pricier name-brand meds covered
Insurance fraud penalties also vary but may include fines, jail time, and repaying insurers for any improper payments. Healthcare professionals can also lose their licenses over prescription insurance fraud.
What Are Some Defenses?
While the penalties are serious, there are some possible defenses in prescription fraud cases:
- No intent – If errors or misunderstandings led to the violation, you may be able to show you never intended fraud.
- Entrapment – If you were coerced into committing fraud by an undercover officer or informant, entrapment may apply.
- Necessity – There are rare cases where breaking prescription laws was necessary for health and safety.
An experienced criminal defense lawyer can review the details of your case and identify any viable defenses based on the specific circumstances. Don’t hesitate to consult a lawyer if you face prescription fraud charges.