2015 Annual Training Conference & Anti-Fraud Expo
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Using Prescription Drug Monitoring Program Data to Identify Fraud
(
Room
Seaport H
)
19 Nov 15
11:30 AM
-
12:30 PM
Tracks:
Fraud in Medicaid Program, Law Enforcement Path
Speaker(s):
Jaya Tripathi, Principal Investigator, The MITRE Corporation;
Judith Coffey, Supervisor Deputy Attorney General, Medicaid Fraud Control Unit, Office of the Indiana Attorney General;
Taya Fernandes, Drug Diversion Analyst, Office of the Indiana Attorney General
Making a prosecutable case against a pill-mill operator and its employees can be challenging. Because these cases always involve a practitioner who has legal authority to prescribe controlled substances, a considerable amount of evidence is required to prove that the prescribing was outside the scope of accepted medical practice and without a legitimate medical purpose. With the advent of prescription monitoring programs there is an opportunity to quickly identify high-volume prescribers and perform an analysis to determine whether they were overprescribing and if so, to what extent. In this session attendees will learn to identify dangerous prescribing trends, identify the lethal combinations and quantities, and use the morphine equivalency tables. Attendees will have a chance to test their knowledge through participation in case examples.
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