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re: Pain cream scandal in Hattiesburg is going nationwide

Posted on 2/2/16 at 9:10 pm to
Posted by AUbagman
LA
Member since Jun 2014
10567 posts
Posted on 2/2/16 at 9:10 pm to
quote:

I'd argue that fleecing giant insurance companies is less harmful to communities than armed robbery and burglary though.



I'd argue it shouldn't fricking matter. Theft is theft. Just because one group is raised in an environment that encourages them to conduct their robbery more delicately, does not make it any better.
This post was edited on 2/2/16 at 9:11 pm
Posted by BRgetthenet
Member since Oct 2011
117688 posts
Posted on 2/2/16 at 9:13 pm to
We're talking varying shades of grey here.

Which is what the doctors and pharmacists are saying about the situation with the insurance companies/drug companies/DEA
This doesn't have a plain dry solution.
Posted by BeachDude022
Premium Elite Platinum TD Member
Member since Dec 2006
34809 posts
Posted on 2/2/16 at 9:58 pm to
I worked for several compounding pharmacies. In the good days, 2013, insurance companies were reimbursing $8000+ per bottle of pain cream. It was the rate THEY set, not us. Even I, as a sales rep, was making $30k a month in commission. Imagine what the pharmacy was making. Life was amazing. Then mid-2014 things came crashing down and insurance companies started dropping coverage all together. Finally Tricare dropped it in May of 2015. Pharmacies and doctors like the ones mentioned on that page are looking for the glory days again and doing anything they can to get back there. Unfortunately they're idiots and they're breaking the law. The glory days are gone. It's no longer covered and if it is, reimbursement is maybe $100. Not worth it. Several pharmacies here in Houston are doing the same thing and will get blown up eventually too.
This post was edited on 2/2/16 at 9:59 pm
Posted by BRgetthenet
Member since Oct 2011
117688 posts
Posted on 2/2/16 at 10:00 pm to
The beginning of the end down here was in 2005. That's when the party basically ended.
Posted by Tiger Hoods
Dixon Correctional Facility
Member since Jan 2016
432 posts
Posted on 2/2/16 at 10:00 pm to
It's compound meds and my wife has a customer in the middle of this crap.... Large Medicade fraud
Posted by tiger91
In my own little world
Member since Nov 2005
36703 posts
Posted on 2/2/16 at 10:08 pm to
What's the actual name of this pain cream??
Posted by Panny Crickets
Fort Worth, TX
Member since Sep 2008
5596 posts
Posted on 2/2/16 at 10:16 pm to
Compounds don't have a brand or label name; they are a mixture of several ingredients.
Posted by Layabout
Baton Rouge
Member since Jul 2011
11082 posts
Posted on 2/2/16 at 10:22 pm to
Next to dentistry, medicine is one of the country's largest criminal enterprises.
Posted by Bourre
Da Parish
Member since Nov 2012
20258 posts
Posted on 2/2/16 at 10:54 pm to
I had a feeling shite would hit the fan with the pain cream scam. That's why I didn't get involved in the first place

ETA: I bet some doctors and pharmacists in BR and the surrounding area have tightening buttholes if shite goes down
This post was edited on 2/2/16 at 10:57 pm
Posted by MrLarson
Member since Oct 2014
34984 posts
Posted on 2/2/16 at 11:01 pm to
Not sure, but I have one of the best BCBS plans and they wouldn't pay for a pain cream. Paid out of pocket, 10.00 per oz. I think. 130 per bottle.

This is big business and I know people that have retired making millions in 5 years

Some of it does work wonders.
Posted by tiger91
In my own little world
Member since Nov 2005
36703 posts
Posted on 2/3/16 at 6:31 am to
Reason I ask is I had a NP offer to write a script for me for something like that when I was having hip pain. I declined but the other nurse talked about him getting kickbacks for it. This was in south Louisiana.
Posted by tigerbandpiccolo
Member since Oct 2005
49284 posts
Posted on 2/3/16 at 6:48 am to
I call on docs who speak for compounding agencies. They write for the pain cream, no doubt.
Posted by Panny Crickets
Fort Worth, TX
Member since Sep 2008
5596 posts
Posted on 2/3/16 at 6:59 am to
Very well could be receiving a kickback.

However, there are also legit investment opportunities for providers with some large volume pharmacies. They offer x number of shares and pay invested providers a set amount every month that isn't based on performance or volume. The providers must disclose this to patients, etc.

Quite often office staff and nurses have no idea how this works and think everything is a kickback. Not saying that this NP wasn't doing some shady shite, just laying out some real scenarios.

Edit for atrocious grammar.
This post was edited on 2/3/16 at 7:13 am
Posted by GeeOH
Louisiana
Member since Dec 2013
13376 posts
Posted on 2/3/16 at 7:16 am to
quote:

Some of it does work wonders.


It all works, the problem is in the scridting, claims, payments, med necessity, etc
Posted by LSU0358
Member since Jan 2005
7918 posts
Posted on 2/3/16 at 7:26 am to
quote:

Now enticements from the pharmacies to the physicians is a no go.


This will be what screws those involved.
Posted by tigerfoot
Alexandria
Member since Sep 2006
56247 posts
Posted on 2/3/16 at 7:32 am to
Pain cream died two years ago, went the way of Medicaid specialty chairs, You could get in on some of that scar cream action.

If I had one crooked pharmacy call me to sell it I had ten. I don't give a shite if it was being reimbursed at, if anyone sold it they are absolute scum.

Posted by tidalmouse
Whatsamotta U.
Member since Jan 2009
30706 posts
Posted on 2/3/16 at 7:34 am to
The prescription strength topical pain creams,lotions,etc.,are really expensive.Come out of Compounding Pharmacies.

It's a bitch to get a PA so your insurance will pay for them.

I had some written to me that was $30 a gram.They gave me a sample,which was basically nothing.

Med Pot is cheaper per gram.
Posted by Panny Crickets
Fort Worth, TX
Member since Sep 2008
5596 posts
Posted on 2/3/16 at 7:42 am to
quote:

I don't give a shite if it was being reimbursed at, if anyone sold it they are absolute scum.


The pharmacies that are accepting payment from the insurance companies that set the price are scum?

Keep in mind that health/rx insurance is very, very big business. Have a look at salary and bonus for the big payers. Good times.
Posted by The Mick
Member since Oct 2010
43096 posts
Posted on 2/3/16 at 8:01 am to
quote:

I'm willing to bet white collar crime like this has robbed way more $$ than thugs have ever stole holding up convenience stores.
Safe bet. And Wall Street execs out-do them all easily. That's the dirtiest, slickest gang in the country.
Posted by SmackoverHawg
Member since Oct 2011
27329 posts
Posted on 2/3/16 at 8:09 am to
quote:

However, there are also legit investment opportunities for providers with some large volume pharmacies. They offer x number of shares and pay invested providers a set amount every month that isn't based on performance or volume. The providers must disclose this to patients, etc.

No. Marketed to doc's as legit. Those that do they're homework will find it is all very sketchy. Ultimately as a physician anything paying worth a shite it illegal in some way shape or form. They're offering the same enticements with drug screens. There are various business models out there, but they are all shady. Common sense should prevail, but when you have docs making $8-10k month and seeing reimbursement get slashed and other bullshite, $15K-$45k/month in "dividends" can be tempting. Especially when they drag out some legal opinion written in their favor. Of course, the opinions never explicitly state the physician is in the clear. Many will go with that and never seek their own counsel on the matter, then claim ignorance when it hits. Common sense should tell you that if writing some creams will pay you multiples of what you make in you office...it's not legit.
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