Alerts

HCPC Alerts is intended to be an ongoing tool intended to keep the public and benefit administrators aware of unscrupulous or abusive health care related activities.

Internet Pharmacies

Websites that allow patients to obtain prescription drugs without being seen by a doctor are raising concern about patient safety.

One such firm, Xpress Pharmacy, generated sales of $250,000,000 in just over a year, just on prescriptions for Hydrocdone - an addictive painkiller. A new Jersey doctor was involved in getting 72,000 of these prescriptions filled.

In addition to patient safety, these websites hamper a benefits plan's ability to monitor fraudulent drug usage. Benefit Managers are advised to:

1. Implement strong membership and case management controls to guard against abuses.
2. make sure that prescription drug claims are processed through a participating pharmacy or the plan's mail order pharmacy.
3. Keep track of how often a particular drug is prescribed for a patient and whether it complies with the suggested dosage.

Patient Hospital Testing

Many hospitals offer to perform certain tests. However, tests done in a hospital can be very expensive for the patient. It is sure that the hospital's charges for one of these tests will be two, three and up to ten times more than what a non-hospital facility would charge. Before any tests are done, the patient should determine what are the hospital's charges.

Almost without exception, any procedure that can be performed at an outside lab (LabCorp, Quest Diagnostics, Bio Reference, Clinical Laboratory Management and others) will cost you substantially less than if done in a hospital. You can locate network lab, testing and therapy facilities through the provider search function of this web site.

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