The Houston Chapter of the Association of Certified Fraud Examiners met last week to discuss medical fraud, particularly as it relates to pharmaceuticals. And with former LEAP Ambassador Bianca Saldierna on the Houston ACFE Board, LEAP students found themselves at the Tanglewood Ballroom alongside approximately 25 certified fraud examiners to discuss pill mills, pharmacy shopping, and the black market.
Following an introduction by Robert Rodgers, the Director of ACFE’s In-Person events…
…featured speaker Yasir Shakoor offered an interesting–and even entertaining–discussion of the diverse types of pharmacy fraud over lunch.
Mr. Shakoor has both a BA and an MHC in Health Care Administration, and he is also a Certified Fraud Examiner, and he was clearly qualified to discuss the different types of fraud.
Following a discussion of common myths and an emphasis on the costs associated with pharmacy fraud, Shakoor made a distinction among (1) fraud–falsely representing services rendered; (2) waste–not reasonably conserving resources; and (3) abuse–which may involve exploiting gray areas in laws or policies and, while perhaps not illegal, is unethical and costly.
The case studies were perhaps the most interesting component of the presentation.
Examples included (1) an individual who hacked into an e-prescription service and issued 18,500 prescriptions (in one day) to purchase sport cars, basketball tickets, and to be “entertained” at strip clubs, (2) a doctor who would offer opioids for the flimsiest of pretenses, and (3) underground organizations that offered substandard, black-market drugs (or, sometimes, just any substance available) in place of the specified medication. It is frightening, costly, and, often, deadly.
Apart from the educational aspects of the lunch, our major reason for attending was to see Bianca Saldierna.
A key LEAP Ambassador in 2016-2017, Ms. Saldierna has remained involved in her alumni years, and she generously invited us to attend this event. With many thanks to Bianca and to ACFE, we eagerly await our next such lunch!
Center for Law, Engagement, and Politics 