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.

© 2021 MMIT

Freelance Reporter Freelance Reporter

Related Posts

https://www.mmitnetwork.com/wp-content/uploads/2021/09/Drug_Benefits_Life_Sciences.jpg
November 23

Will ‘Build Back Better’ Spell Disaster for Pharma Innovation?

READ MORE
https://www.mmitnetwork.com/wp-content/uploads/2021/11/WordPress-Featured-Image-health-plan-weekly-Wall-Street-Isnt-Sweating-Cignas-Third-Quarter-MLR-Miss.jpg
November 23

Big Three PBMs’ 3Q Results Make Up for Insurer Disappointments

READ MORE
https://www.mmitnetwork.com/wp-content/uploads/2021/11/WordPress-Featured_AdobeStock_442155384.jpg
November 23

SCAN Health Opts to Invest in Medication Adherence Tool

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