Understanding Pharmacy Fraud: Lessons from the Houston ACFE Lunch

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!

Murder Most Foul: An April Adios

For all Pre-Law Society members, our April was the last get together of the academic year. But for one unlucky member, it was, at least in the world of fictional fun, the last meeting ever. That’s because our social involved a murder mystery, something of a theme for our sinister solicitors.

Our officers and activity committee put together treats to bribe encourage us to attend, and it worked!

A healthy 30 or so students attended, a reflection of our growing sociality as an organization.

Mikaela Baires was the unlucky victim. Indeed, she was doubly unlucky, inasmuch as the murder weapon was a laxative, giving new meaning to Shakespeare’s phrase “murder so foul” (thankfully, we did not meet at the beautiful Wynne Home this year…).

The suspects were Mikaela’s peers: Chrissy Biello…

Jose Carreno…

Katherine Burnett…

Madison Cawthon…

Neehal Ahmed…

and Niya Thompson.

Given the suspects–any one of whom is capable of such a dastardly act–it was going to be a tough evening for our social sleuths.

Thankfully, there were four clues uncovered, and throwing Miranda out the window, the suspects were questioned without their lawyers being present.

After much debate, hand-wringing, and interrogation, the law-enforcement, apparently imitating the Keystone Kops, accused the wrong person–Katherine Burnett–perhaps motivated by a strong desire to sequester her from society for eternity, or at least until they graduate.

In fairness, the actual murderer, Jose Carreno, broke the rules of the game and lied. Who knew a murderer would lie about his whereabouts? Following the game, Jose vowed that, “when things have settled a bit, I will pursue as my primary goal in life the killer or killers who slaughtered Nicole and Mr. GoldmanMikaela Baires.”

On a happier note, Madison Cawthon led the speed debating contest.

Befitting our status as future lawyers in society–and, perhaps, lawmakers–we spent our time arguing over trivialities ending in ludicrous judgments.

Neehal Ahmed, for example, argued that it should be illegal to text a single “k” to indicate affirmation via messaging.

The debate over whether “ttyl” should be punishable by firing squad was tabled. And thank God we didn’t even get to people who use odd text colors or emojis.