Important Fraud Alert for Physicians and Advanced Practice Clinicians

KentuckyOne Health

CHI's Corporate Responsibility Program and Legal Services Group have recently received multiple notifications regarding fraudulent schemes against physicians and advanced practice clinicians.

The first scheme involves the faxing of orders for medications and/or durable medical equipment and supplies.

  • Typically, the faxes include a completed order form for an actual patient that is under the care of the provider and requests the provider to sign the form and return it as soon as possible or the request is marked urgent or immediate attention needed.
  • The order forms typically include pre-filled information about the provider including the provider's NPI number, clinic address and phone number.
  • CHI has identified incidents in which the faxed orders are for diabetic supplies when, in fact, the patient has not been diagnosed with diabetes.
  • CHI has also seen orders for expensive, compounded topical medications, topical anesthetics and omeprazole capsules that were not indicated.
  • Providers are urged to verify the accuracy of the orders prior to signing and returning these types of requests. If a physician or APC receives a fraudulent order request, he/she should notify the local Corporate Responsibility Officer (CRO).

The second scheme involves persons posing as drug enforcement administration (DEA) agents threatening to arrest a provider unless a fine is paid.

  • The caller generally has the provider's NPI number, DEA number, place of medical training and states there is a warrant for arrest of the provider.
  • To make the call seem realistic, the caller identifies himself or herself as a Special Agent and uses the name of high level persons within the DEA including the name Robert Patterson, who was the former DEA chief.
  • An offer to make the arrest warrant go away for thousands of dollars is typically conveyed.
  • Due to this and other schemes against the public, the DEA has asserted that their DEA agents will never contact members of the public by telephone and demand money or any other forms of payment.
  • Additionally, should you receive such contact CHI's Government Contact Protocol should be followed. This protocol directs the person contacted by telephone to request the agent's identification and advise the agent that he or she will be called back to verify identity. The person that receives the call should immediately contact the local Corporate Responsibility Officer (CRO), manager or supervisor, National CRO at 303.383.2670, the local Legal Services Group member or the CHI Ethics at Work Line at 800.261.5607.
If you have any questions or need additional information, please contact:

Read this Legal Bulletin for more information.