Uncovering a $6 Million Kickback Scheme: Lessons from a Pharmacy Fraud Case

This podcast episode details a sophisticated healthcare fraud where a struggling pharmacy engaged in a kickback scheme, billing federal insurance programs nearly $11 million through a fake employee and a deceptive billing code. Internal audit and assurance professionals can gain critical insights into identifying red flags related to third-party relationships, employee verification, and billing anomalies, emphasizing the importance of robust controls and due diligence in preventing similar financial crimes.