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Identifying Pill Mills

Identifying Pill Mills. Timothy J. McClure, Deputy Director Medicaid Fraud Control Unit Office of the Attorney General. Definition.

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Identifying Pill Mills

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  1. Identifying Pill Mills Timothy J. McClure, Deputy DirectorMedicaid Fraud Control Unit Office of the Attorney General

  2. Definition A pill mill is a medical practitioner’s office, clinic or health care facility where the practitioner(s) routinely dispenses controlled substances outside the scope of professional practice and not for legitimate medical reasons.

  3. Premises indicators • May not resemble a traditional doctor’s office

  4. Premises indicators • Long lines at the clinic, often before the clinic opens • Presence of a security guard/dog • People congregating outside • Open drug dealing

  5. Premises indicators • Clinic accepts only cash • Patients from out of area • Clinic owner not a physician…maybe he’s a businessman…

  6. Practice indicators • Appointments not needed • No medical history taken • No physical exam performed • No tests ordered • No referrals to specialists • Urine drug screens not performed or results ignored • Addicts knowingly treated

  7. Practice indicators • INSPECT not used or ignored • Numerous patient overdoses, some resulting in death • Numerous patients referred for drug treatment • Other crimes occurring, e.g., Medicaid fraud, sexual battery

  8. Prescribing indicators • Patients get similar controlled substances • Dishing out pills is only treatment option • Large pill counts prescribed • Early refills given • More than one long-term opiate prescribed • “Holy trinity” often prescribed…

  9. Jeffersonville

  10. Evansville

  11. Corydon

  12. Trends • No signs of slowing down • Purchasing drug stores

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