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NCPDP Impersonator: Phone Scam Overview



31 Dec 2016

Prescription drug use in the United States is very prevalent. According to data from the Mayo Clinic, nearly 70% of Americans are taking at least one prescription drug. Since prescription drug use is so common, the National Council for Prescription Drug Programs (NCPDP) carefully monitors U.S. pharmacies to make sure they adhere to safety and billing regulations.NCPDP Impersonator Phone Scam

Scam artists knowing that many people take prescription drugs, will impersonate NCPDP officials and try to dupe pharmacies into handing over sensitive financial information.

How Does the NCPDP Impersonator Phone Scam Work?

The NCPDP phone scam targets pharmacies. The caller's goal is to get pharmacies to provide lists of patient information, which will then allow them to file fraudulent Medicare claims and fraudulent tax returns.

In this scam the caller claims to be a NCPDP official. They tell the pharmacist that they need to verify the pharmacies information, which can include:

  • The name of the pharmacy owner
  • The national provider identifier number
  • Pharmacy email addresses
  • The pharmacy phone number
  • Federal tax identification number (EIN)

The caller will often threaten fines or warn that the pharmacy will be reported for non-compliance if they do not cooperate with the caller's demands. Once the information has been given to the scammer they will use the EIN and other information to illegally file tax returns and other fraudulent activities. It can be a nightmare for pharmacies to recover from this fraud. In another variation of this scam, the caller may request information on individual patients. This is not a only a violation of the Health Insurance Portability and Accountability Act (HIPAA), but it also exposes patients to the risk of identity theft and Medicare fraud. 

How to Protect Yourself From This Scam

Pharmacies need to work closely with the NCPDP to verify their license and other important information. They need to be able to tell the difference between real NCPDP employees and impostors. Here are some warning signs to look out for.

Requests for large amounts of information.

The NCPDP may occasionally contact you for information. However, they don't request overly sensitive information via unsolicited phone calls.

Refusal to identify.

If you aren't able to identify the caller's identity, then you should inform them that you'll need to call back later. After hanging up, reach out directly to the NCPDP at 480-477-1000 or [email protected].

How to Report This Scam

If a scammer calls you claiming to be from the NCPDP, then you should immediately contact the NCPDP and report it to the FCC. Provide as much information as possible to maximize the chances that they will find the people responsible. You can also help warn other pharmacies and run reverse phone lookups on numbers that claim NCPDP representatives. Thanks to our users we have feedback on millions of U.S. phone numbers. You can check numbers for suspicious behavior in our online phone book or our free phone number tracing app for iPhone.

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