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Answer:
Two (2) of the Five (5) Common Examples of Fraud Listed in the Pharmacy
1. Drug diversion: Pharmacists may take prescription drugs out of official circulation and sell them illegally on the streets, often by dispensing prescriptions short by a few pills to slowly accumulate enough to sell[1].
2. Benefiting from bribery/Illegal kickbacks: Pharmacists may give money to doctors for exclusive referrals, or provide gift cards to patients to switch their prescriptions. This type of fraud is also known as a "kickback".
3. Automatic refills fraud: Pharmacies may automatically refill prescriptions even when patients no longer need the medication, then bill Medicare or Medicaid for these unnecessary refills without the patient's knowledge.
4. Drug switching: This occurs when a pharmacy fills a prescription with a different medication than what was prescribed, such as switching a capsule to a tablet or substituting a generic drug for a brand name while billing for the more expensive option.
5. Fraudulent billing schemes: These can include billing for nonexistent prescriptions, billing for brand name medications when dispensing generics, or billing multiple payers for a single prescription.
These fraudulent practices allow pharmacies to improperly bill government healthcare programs and increase their profits at the expense of patients and taxpayers.
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