An Illinois nurse was sentenced om September 16, 2021, to four years of probation for drug diversion and healthcare fraud charges. The Illinois nurse was also ordered to pay a $500 fine along with a $200 special assessment.
According to court documents, the nurse diverted Hydrocodone pills, a Schedule II controlled substance, from a patient and defrauded the Medicare program of the cost of the pills.
In 2018, the Illinois Nurse was employed at a center for adults with intellectual disabilities. Between August 20, 2018, and October 30, 2018, the nurse obtained possession of 25 Hydrocodone pills that he falsely claimed he dispensed to a resident in the center, but which he diverted for his own personal use. He also took three Hydrocodone pills intended for the same resident and replaced those pills with Tylenol at three separate locations.
The investigation was conducted by the United States Department of Health and Human Services Office of Inspector General’s Office of Investigations and the Illinois State Police Medicaid Fraud Control Bureau.
If you suspect or know of an individual who is not complying with your facility’s policies and procedures for management of controlled classes of medications, is in violation of healthcare laws, or may be defrauding government healthcare programs, you should report this activity to your supervisor, department manager, the compliance and ethics officer, or the administrator, or you can call the Med-Net hotline. You can also contact your local office of the U.S. Department of Health and Human Services, Office of Inspector General, or call 800-447-8477.
Issue:
Drug diversion is a growing problem in healthcare. Licensed staff who have access to controlled medications may be at risk for committing fraud and theft of controlled substances if they develop a substance abuse problem. All leaders in healthcare should be aware of the warning signs of a controlled substance disorder and be prepared to address any acts of drug diversion properly and quickly.
Discussion Points:
- Review your policy and procedures on preventing, identifying, and responding to drug diversion. Update as needed.
- Train all appropriate staff on actions that can be taken to prevent, identify, and respond to any suspicion of drug diversion, and what should be done if it occurs. Document that these trainings occurred and file the signed document in each employee’s education file.
- Periodically audit to ensure that all controlled substances are accounted for each shift, and that proper documentation of all controlled substances has occurred.
