The Vendor and the Supplier

Who Are the Vendor and the Supplier?

Contributing to the fragmentation of the healthcare industry is another category of P-HCC players called vendors and suppliers. They are a blend of professional subcontractors. Vendors include healthcare professionals who provide direct patient care, such as nurses, doctors, physical therapists, and home health aides, as well as professional support services, such as billing companies or case management services. Suppliers include companies such as diagnostic laboratories, pharmacies, and medical device manufacturers. Vendors and suppliers are found throughout the P-HCC as subgroups within each market-player category.

What Are Some Examples of Vendor and Supplier Fraud?

The range of activity is significant and varies by the type of vendor or supplier. A growing area of concern is the pharmaceutical industry. The range of fraud starts with recipient drug abuse. It may involve professional staff drug abuse. The fraud scheme could be finding avenues of drug diversion for illicit use and sale. An egregious scheme involves the introduction of counterfeit pharmaceutical drugs into our normal supply chain. The second level is adulterated drugs. This involves actual medications that are altered or diluted. Pharmaceutical issues may also take the form of government-sponsored program abuse. One such example is known as 340 B program abuse; in this fraud scheme, providers or entities divert manufactured discounted drugs to unqualified ...

Get Healthcare Fraud: Auditing and Detection Guide, 2nd Edition now with the O’Reilly learning platform.

O’Reilly members experience books, live events, courses curated by job role, and more from O’Reilly and nearly 200 top publishers.