Opioids – Don’t Get Sucked In!

“Two pharmacists sentenced to 19 and 20 years in prison and ordered to pay $5 million in restitution to the state of Georgia to combat the opioid epidemic,” reads the news heading from the Department of Justice story based upon the criminal activity of two pharmacists.

“Rosemary Ofume and Donatus Iriele have each been ordered to pay $2.5 million in community restitution… The defendants… formerly owned the Medicine Center Pharmacy in Atlanta, Georgia. They were sentenced… to 19 and 20 years in prison, respectively, for illegally dispensing controlled narcotics to customers of the AMARC ‘pill mill’ pain clinic.”

“The defendants used their pharmacy to supply pills to patients of a known ‘pill mill’ and then laundered millions of dollars to conceal their crimes,” said U.S. Attorney Byung J. “BJay” Pak.

“All health care professionals are put on notice to remember: you are to do no harm. And if you intentionally ignore this charge, you are going to be treated the same as a street-corner drug dealer in this war on opioid abuse,” said Dennis M. Troughton Sr., Director, Georgia Drugs & Narcotics Agency.

Last month, we reported that a Kentucky pharmacist was sentenced to eight years in federal prison for conspiring to distribute oxycodone and money laundering by filling forged prescriptions from outside of the state. Michael Ingram, who owned and operated Hometown Pharmacy of Georgetown, KY, was ordered to forfeit an amount in excess of $450,000.

The bottom line is – Don’t get sucked into distributing opioids for the allure of making a profit. If you know of any health care professionals who are circumventing their duties to do no harm, report them to the Department of Justice or the DEA.

OptumRx Prohibits Mailing Prescriptions

Optum has recently faxed out notices reminding pharmacies that they should not solicit members for mail delivery or mail any covered prescription services to members. This includes US mail or shipping via any common carrier (FedEx, UPS, DHL).

Unless you have a specialized mail-order contract with OptumRx, this will be considered a violation of contract.

These notices can be somewhat deceiving as they may only list a certain benefit plan and a few BINs. If you read the notice closely, it does state that mailing is subject to termination from all ORx networks.

Optum is not the only PBM that prohibits mailing prescriptions. Humana and Express Scripts also have this stipulation in their provider manuals. Caremark states that if you ship more than 25% of the prescriptions you bill to them in any month, you are no longer eligible to be contracted under the retail pharmacy network.

Please check your contract, provider manual, or PSAO for further information.