Prescription Drugs Oxycontin Abuse And Diversion And Efforts To Address The Problem Report To Congressional Requesters

GAO-04-110 Prescription Drugs: OxyContin Abuse and Diversion and Efforts to Address the Problem

Prescription Drugs: OxyContin Abuse and Diversion and Efforts to Address the Problem

An obsessive true crime investigation of a bizarre and unlikely perpetrator, who’s serving the opioid epidemic’s longest term for illegal prescriptions — four life sentences Written in the tradition of I'll Be Gone in the Dark and True Crime Addict, combining Dopesick's heart rending portrayal of the epidemic's victims with Empire of Pain's examination of its perpetrators This haunting and propulsive debut follows a journalist’s years-long investigation into his father's old classmate: former high school valedictorian Paul Volkman, who once seemed destined for greatness after earning his MD and his PhD from the prestigious University of Chicago, but is now serving four consecutive life sentences at a federal prison in Arizona. Volkman was the central figure in a massive “pill mill” scheme in southern Ohio. His pain clinics accepted only cash, employed armed guards, and dispensed a torrent of opioid painkillers and other controlled substances. For nearly three years, Volkman remained in business despite raids by law enforcement and complaints from patients’ family members. Prosecutors would ultimately link him to the overdose deaths of 13 patients, though investigators explored his ties to at least 20 other deaths. This groundbreaking book is based on 12 years of correspondence and interviews with Volkman. Eil also traveled to 19 states, interviewed more than 150 people, and filed a Freedom of Information Act lawsuit against the Drug Enforcement Administration that led to the release of nearly 20,000 pages of trial evidence. The American opioid epidemic is, like this book, a true crime story. Through this one doctor’s story, an era of unfathomable tragedy is brought down to a tangible, and devastating, human scale.

U.S. health care is a $2.5 trillion system that accounts for more than 17 percent of the nation’s GDP. It is also highly susceptible to fraud. Estimates vary, but some observers believe that as much as 10 percent of all medical billing involves some type of fraud. In 2009, New York’s Medicaid fraud office recovered $283 million and obtained 148 criminal convictions. In July 2010, the U.S. Justice Department charged nearly 100 patients, doctors, and health care executives in five states of bilking the Medicare system out of more than $251 million through false claims for services that were medically unnecessary or never provided. These cases only hint at the scope of the problem. In Phantom Billing, Fake Prescriptions, and the High Cost of Medicine, Terry L. Leap takes on medical fraud and its economic, psychological, and social costs. Illustrated throughout with dozens of specific and often fascinating cases, this book covers a wide variety of crimes: kickbacks, illicit referrals, overcharging and double billing, upcoding, unbundling, rent-a-patient and pill-mill schemes, insurance scams, short-pilling, off-label marketing of pharmaceuticals, and rebate fraud, as well as criminal acts that enable this fraud (mail and wire fraud, conspiracy, and money laundering). After assessing the effectiveness of the federal laws designed to fight health care fraud and abuse—the antikickback statute, the Stark Law, the False Claims Act, HIPAA, and the food and drug laws—Leap suggests a number of ways that health care providers, consumers, insurers, and federal and state officials can bring health care fraud and abuse under control, thereby reducing the overall cost of medical care in America.