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xmag.com : February 2003: How to get high off the OHP

Everyone looooooves Vicodin. And its cousins Percocet, Oxycontin, Darvocet, Demerol, Methadone, etc. That's because they're all opiate-based drugs. The mother molecule is opium which is refined into heroin. The aforementioned synthetic opiates work similarly, giving a sense of euphoria to the user, but without the physical and psychological stigma of having to use a needle. And at about fifty cents per pill, it's an easy way to maintain a low-grade opiate addiction. Vicodin is the second-most widely prescribed drug in the U.S. and it's the most frequently prescribed drug on OHP.

So what's the scam? How does one get high off the Oregon Health Plan? Well, here's how it works.

First you have to be poor, or prove you're poor. Not just working-class poor. No, OHP won't help you out if you're a hard-working stiff that just needs insulin or excision of a nasty tumor. You gots to be filthy poor. Take yourself to the level of Lori Pond and Michelle Duffy, throw in a chronic methamphetamine habit, let your teeth rot out and you're getting close. Make Jeff Foxworthy's You Might Be a Redneck If... album your personal mantra and make sure you have about three or four illegitimate children. Extra points for morbid obesity and poor hygiene. Once you've done your part to make the world a worse place, I'm sure you'll feel that the state owes you a favor. Society really screwed you, after all, so it's high time they paid up. How can the state expect you to survive on that measly SSI check? You gots to get your groove on, and you just aren't clearing enough on the dole.

Apply for OHP. It's not hard to do. Just walk into any hospital ER with a runny nose and they'll sign you up for it. A social worker will come down to the ER and take care of all that annoying paperwork for you. After that, just sit on your can for four to six

weeks until your OHP card and paperwork arrive. Hell, you weren't planning on looking for a job anyway!

When your paperwork arrives, OHP will tell you to get assigned to a PCP (Primary Care Provider). Ignore this. Most M.D.'s, dentists and healthcare professionals in private practices don't take OHP. Why not? Because they reimburse providers' bills at about thirty cents for every dollar submitted. I don't know anyone who will work for one-third wages and that's why you won't be able to find a regular doctor. [Interestingly enough, OHP bitches about the fact that there aren't enough doctors for their patients. Now you know the reason why. Not only do they not pay for shit, but they add insult to injury by dumping filthy indigents onto the clinic's nice clean office furniture. Providence Health Plan quietly ejected almost all of their OHP clients, as did Kaiser, if this is any indication of how big of a money-loser OHP is.]

This is not a problem. OHP says you can go anywhere for treatment if you can't find a PCP, which we've already established will occur. That means that you can go to the ER or Urgent Care and get seen right away. You may have to wait behind somebody with a heart attack or multiple gunshot wounds, but you've got real problems too.

Now, one cannot go into the ER or Urgent Care and just request Vicodin outright. However, a simple complaint of a migraine, lower-back pain, or other minor injury will generally get you a nice stash. Make sure you concoct a plausible story and know how to fake the symptoms of an injury. You don't have to be a Julliard-trained actor and for shit's sake don't overdo it. Doctors aren't stupid, you know. Once you know how to get your goodies, make sure you move around to different ER's and Urgent Cares around the city. You can usually hit them once or twice a month without arousing suspicion. The hundreds of Vicodin that you score can then be used for your own personal enjoyment or sold on the street for a tidy profit. OHP will pick up the tab. Your only investment is time and bus fare or gas money.

This scheme will also work if you prefer Xanax or other Valium-like sedatives. These are popular amongst meth-heads because they help you come down after a hard night of car-prowls and creating bastard children. Just complain of anxiety and stress. Saying something along the lines of "I feel the walls closing in around me" will generally nail it.

So there you have it. That's how you get high on the taxpayers' tab. This scheme will work with most other insurance plans, too.

Sound implausible? An Oregon State Auditor told me about a medication use study that basically confirmed how widespread the problem is. The study took a random sampling of OHP patients and tracked their Vicodin use. They found that based on the number of Vicodin pills bought versus the number of patients, Vicodin use was close to THIRTY tablets per client per day. This is not to say that every patient used that much. It was just a

few individuals burning through hundreds of pills per month, using the scam I've mentioned.

So go for it! Still scared? Let's be clear that OHP is doing nothing about this. They're tied down with budgetary and administrative concerns and the fear of litigation has paralyzed them. After all, in order to determine if one is abusing prescription medicines, a chart review has to occur and that's fraught with all sorts of privacy and confidentiality issues.

Private HMO's and insurance plans do random reviews of their clients and red flags are raised if they notice that a person is burning through hundreds of Vicodin tablets per month. The client can then be ejected from the health plan and prosecuted for felony-level insurance fraud if sufficient evidence exists, but most of the time, their physician is notified. The physician then reviews the prescription record and will halt or taper their prescribing practices. But bear in mind that this is only true for private HMO's. OHP rarely engages in this process, so very few drug-seekers are caught.

The easiest way to catch OHP drug-seekers is to simply call the pharmacy. Most pharmacies are coordinating all of their data on to one common nationwide database. Not only is it easier to safely dispense accurate and timely prescriptions, but an entire history of prescriptions can be tracked. A person can be trying this scam in multiple cities and states, but the record of their drug use will always follow them, making them very easy to catch. Some are prosecuted for insurance fraud, some for theft of service, some for abuse of prescription drugs. Some are stupid enough to alter their prescriptions or try phoning fake prescriptions in to the pharmacy, like Florida Governor Jeb Bush's daughter, who attempted to get Xanax and was easily caught. Here in Portland, a man was shot dead on Broadway in a dispute over prescription drugs.

But don't worry. OHP rarely catches drug-seekers. They have no motivation to do so, as long as they are funded by the taxpayers. However, the Oregon Health Plan is undergoing radical budget cuts, so hurry.

NOW is the time to get high off the OHP.




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