Sunday, November 1, 2015

Valeant Needs More Cowbell

As the Blue Oyster Cult of financial journalists, short sellers, and investigators (including  Andrew Left, Roddy Boyd, John Hempton, Jonathan Rockoff, Charles Ornstein, Caroline Chen...) fervently ascend through their literary scales of Don't Fear the Reaper, despite Wall Street's fatigue, the Bruce Dickinson in me can't help but want more cowbell. 

After reading through more transcripts, analysis, powerpoints, investor calls and letters than I could ever want, I found that I still had a fever....and the only prescription was more cowbell.

Turns out, that additional analysis of accounts receivable data generated by Philidor has uncovered an odd subset of prescriptions which apparently were never meant to be filled.

As is to be expected of Valeant, it's not straightforward so let's keep it as simple and rhythmic as possible.

On June 23rd, Philidor claims that prescription 40031052 was dispensed and shipped. Philidor's records also show that they are due $973.21 from the the PBM/Processor Caremark.




What is quite odd about this particular receivable is the shipping history associated with this prescription. Instead of originating at R&O on June 23rd, it actually originates in Hammond, Indiana on June 29th, before making its way to R&O in Camarillo, California, where it was received on July 2nd and signed for by "Al." This is troubling for many reasons. At first I  thought perhaps it was a return, but that can't be the case, because it's a credit on the receivables. It would also stand to reason that if it were a return, the same exact script number would be referenced with a reimbursement due to Caremark, but this is the only reference to prescription 40031052.


In an even stranger twist there are prescriptions which appear to be billed to payors, but were never shipped into or out of R&O. It's like the Wonka factory for price gouged drugs. As seen here, prescription 40045409 claims to have been filled on July 6th, and shipped on July 7th, with the payor on the hook for $1017.30.


When you refer to the shipping history for that particular prescription though, you can see it wasn't even scheduled to be picked up until July 9th at 7:46pm, and the scheduled pickup was from Oak Park, IL, destined for Camarillo, California. It never got there though. You can see from its shipping history that it wasn't even scanned in by UPS.

More troubling still for Philidor and Valeant is that these two simple examples are not the only examples uncovered in their accounts receivables. These are just two little plunks of the stick on the cowbell.

Using other pharmacy's provider numbers seems bad enough, but billing for prescriptions which were never filled seems like outright insurance fraud, which would be in addition to whatever insurance fruad they were already perpetrating.

Plunk, plunk, plunk, plunk, plunk, plunk, plunk...
All our times have come.....


For those curious, the origins of these phantom shipments I've uncovered thus far are:

CHICAGO
MARYSVILLE
MOKENA
MT PROSPECT
DENVER
HINSDALE
OAK PARK
SIMI VALLEY
SANTA MONICA
EDWARDSVILLE
ENCINITAS
ADDISON
BREMERTON
HENDERSON
SAN FRANCISCO
LAKE MARY
SANTA ANA
NORTH RIVERSIDE
LA PORTE
WEST DUNDEE
PALM BAY
EVANSTON
LOS ANGELES
TUSCOLA
SAN RAMON
MOUNTAIN VIEW
SAN RAFAEL
PHILADELPHIA
CALABASAS
SAN DIEGO
WASHINGTON
NEW ALBANY