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Re: DewDiligence post# 77067

Friday, 05/01/2009 11:20:48 PM

Friday, May 01, 2009 11:20:48 PM

Post# of 257268
Any physician can precribe a medicine for off- label use. That is not a crime or insurance fraud. It is not even malprqctice if it is within the 'standard of care within the community'.

The problem with Latisse and Lumigan is that they are 2 distinct separate products. I can prescribe Lumigan for glaucoma. I can prescribe Latisse for cosmetic indication. The insurance company will pay for Lumigan for glaucoma because it is a covered medical condition under all insurance policies. Most, if not all insurance policies will not pay for purely cosmetic procedures or medicines. So most will NOT pay for Latisse because it is purely for a cosmetic indication.

If I proactively prescribe Lumigan (the patient doesn't have glaucoma) and instruct the patient to use Lumigan for cosmesis, as a way to circumvent the insurance companies guildlines for reimbursement, I have committed insurance fraud, IMO.

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