Anytime payment is guaranteed for a service you can bet there are fraudulent operators. For meds...certain Ointments or novel suspensions are falsely prescribed by docs or p.a.s in on the deal. Rx makes very expensive stuff...dispenses it...gets paid...and splits some the profits with the collaborators. I have heard in some cases, people get fraud prescriptions for bronchodilator inhalants...rx gets paid...buys the inhaler back from patient...at a lower price than reimbursement...then sells it to drug users to open up their bronchioles so they get a faster and deeper rush from their inhaled drugs. So rx gets paid twice...and spends a bit. Big profit. Total corruption. Taxpayers pay. Fraudsters should get a prison sentence that ends on their 78th birthday.
I pay hard cash for my compounded meds and I doubt the biz is involved in stuff you described...too much risk of reputation.
But, I can see how smaller compounders might play games