Prime Sees Major Spike in Telemedicine-Based Rx Fraud

Prime Therapeutics LLC saw telemedicine schemes contribute to a 60% year-over-year increase in reported false claims from 2020 to 2021. The Blue Cross Blue Shield affiliate-owned PBM, which is in its second full year of an artificial intelligence-powered fraud, waste and abuse (FWA) reduction program, reported that the program saved its health plan clients $285 million in 2020, in part because it detected telemedicine-driven schemes.

Elan Rubinstein, Pharm.D., head of pharmacy benefits consulting firm EB Rubinstein Associates, says it’s unsurprising that increased telemedicine led to a spike in prescription fraud.

© 2022 MMIT
Freelance Reporter

Freelance Reporter Freelance Reporter

Related Posts

pills
September 22

Report Shows Limited Access to Opioid Use Disorder Treatments for Medicare Beneficiaries

READ MORE
cms-website
September 22

Drug Price Negotiation Will Require New CMS Regulations, Staffing

READ MORE
fda-sign
September 22

Accelerated Approval Prices Are Unrelated to Clinical Value, Study Says

READ MORE

GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND

Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today