September 18, 2019
Florida-based compounding pharmacy
Diabetic Care Rx LLC, also known as
Patient Care America, together with two of its executives, CEO
Patrick Smith and VP of Operations
Matthew Smith, and the private equity firm
Riordan, Lewis & Haden Inc., will pay
$21.36 million to resolve a case brought by two whistleblowers under the False Claims Act alleging that they paid unlawful kickbacks to secure referrals for patients covered by TRICARE, the federal healthcare program that covers military members and their families. The pharmacy paid patient recruiters to target military members and their families for the prescription of compounded creams and vitamins formulated to ensure the highest possible reimbursement from TRICARE. The marketers in turn paid doctors who issued the prescriptions, often without seeing or even speaking to the purported patients. In addition, the pharmacy and marketing company often covered patient copayments through a sham charitable organization affiliated with the marketing company. Private equity investor RLH was alleged to have known about and agreed to the kickback scheme. Whistleblowers
Marisela Medrano and
Ada Lopez were, respectively, the former Director of Marketing and the Reimbursement Services Manager of PCA. They will receive a yet-to-be-determined share of the U.S. recovery.
DOJ;
SD FL