Physicians, chiropractors and pharmacies who provide treatment and prescriptions to workers' compensation applicants in California, should be aware of new proposed legislation by state Sen. Mark DeSaulnier and Assemblyman Jose Solorio which would limit prices of medically necessary compounded drugs by adding them to the government's fee schedule.
The Los Angeles Times article noted that "Critics of the use of compounded drugs point to a sharp rise in the bills submitted to the State Compensation Insurance Fund, the state's biggest workers' comp insurer. Billings for compounded drugs reached $28 million, or 24% of the fund's total prescription billings last year — from a number so low the previous year that State Fund didn't bother to track it." Rand Corporation is compiling a study on this issue.
An effort last year to discourage the use of compounded drugs — especially those concocted by pharmacists, given by doctors to their patients and billed to insurers — failed to get through the state Legislature. Doctors were among those lobbying against it.
One of the focal points of this bill will be the third party pharmacies that are involved in providing the compounds to the physicians and chiropractors and billing the workers' compensation carriers. According to the L.A. Times article there are concerns about medical necessity and "[s]uspicions of abuse have been fueled by advertisements for compounded drugs on Craigslist two years ago that offered 'doctors who see work comp patients … $20K a month dispensing meds.'" The ad supposedly said: "There are no legal issues, no billing — we do the billing, no costs or risks to the doctor," the ads said. "We have over 400 doctors in California." The ads further stated that "we have a great product an Anti-Inflammatory Cream that's compounded and has spectacular results" and that doctors could make a $141.60 profit on every prescription.
The L.A. Times article discussed one leading compounding pharmacist Robert Nickell, president of HNP Pharmaceuticals in Torrance. According to the article, Nickell and HNP have been part of a network of dozens of related pharmacies and third-party medical billing companies, many registered at the same Torrance address as HNP.
Thoughts And Articles From Attorneys At Green and Associates Who Represent Professionals, Businesses and Invididuals In Administrative, Criminal Defense, Regulatory, Health Care and Civil Litigation Matters In California
Media Links To Press Or Past Cases
- Green Interviewed By ABC About Alcohol Drug Detox Facility
- Green Quoted In L.A. Times' Article On Doctor Case
- Green Quoted In Sacramento Bee Article On Crackdown On Medical Spas
- Green Obtains Probation For Client In Iowa Film Tax Credit Case
- Green Quoted In L.A. Times Article On Maximus: "Medical Workers Were Allowed To Keep Practicing Despite Failing Drug, Alcohol Tests"
- Tracy Green Quoted In Article On San Diego Chargers' Doctor
- Green Quoted in L.A. Times Article Re: Temp Nursing Firms
- Firm Represents Individual Charged With Film Financing Bank Fraud
- Firm Represents Doctor Charged In Medi-Cal Fraud Case in Valley
- 7 Charged In Valley Medi-Cal Fraud Case - Green Brought In And Obtains Dismisal Of Charges Against Physician
- Article On Swedish National Involving Importation Of Rare Ferrari, Maclaren And Rolls Royce - Green Brought In On Restitution Issues
- Green Represents Judge And Settles Suit Alleging He, Others Laundered Money
- Tentative Settlement in Federal Suit Involving Judge Murphy Falls Through - Green Quoted
- AG Brown Announces Arrests in Health Care Scam - Green Brought In On Defense
- Green Represents Vending Cart Owners In Controversy With City of Santa Monica
- State Presses Case Against Noted Plastic Surgeon - Green Brought In On This Case
- State Hit Hard By Medi-Cal Fraud - Green Quoted
- Green Represents Lake Tahoe Doctor Accused Of Medi-Cal Fraud And Over-Prescribing Addictive Drugs (Dismissal Obtained)
- L.A. Times Article Re: Victim Subject Of IRS Probe - Green Quoted
- San Francisco Examiner Article Re Immigration Fraud - Green Quoted
- Green Obtains Reversal On Appeal Of Retired Sheriff's Conviction
DISCLAIMER
DISCLAIMER: Green & Associates' articles and blog postings are prepared as a service to the public and are not intended to grant rights or impose obligations. Nothing in this website should be construed as legal advice. Green & Associates' articles and blog postings may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents and contact their attorney for legal advice. The primary purpose of this website is not the commercial advertisement or promotion of a commercial product or service and this website is not an advertisement or solicitation. Anyone viewing this web site in a state where the web site fails to comply with all laws and ethical rules of that state, should disregard this web site.
The information provided on this website is for informational purposes only. It is not intended to create, and does not create, a lawyer-client relationship with Green & Associates, Attorneys at Law. Sending an e-mail to Tracy Green or Ann Schneider does not contractually obligate them to represent you as your lawyer, or create any type of client relationship. No attorney-client relationship will be formed absent a written engagement or retainer letter agreement signed by both Green & Associates and client and which specifies the scope of the engagement.
Please note that e-mail transmission is not secure unless it is encrypted. E-mail messages sent to Ms. Green or Ms. Schneider should not include confidential or sensitive information.
The information provided on this website is for informational purposes only. It is not intended to create, and does not create, a lawyer-client relationship with Green & Associates, Attorneys at Law. Sending an e-mail to Tracy Green or Ann Schneider does not contractually obligate them to represent you as your lawyer, or create any type of client relationship. No attorney-client relationship will be formed absent a written engagement or retainer letter agreement signed by both Green & Associates and client and which specifies the scope of the engagement.
Please note that e-mail transmission is not secure unless it is encrypted. E-mail messages sent to Ms. Green or Ms. Schneider should not include confidential or sensitive information.
Contributors
Third Party Privacy Policy
We use third-party advertising companies to serve ads when you visit our website. These companies may use information (not including your name, address, email address, or telephone number) about your visits to this and other websites in order to provide advertisements about goods and services of interest to you. If you would like more information about this practice and to know your choices about not having this information used by these companies, please email us.
