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Compounding Pharmacy Fraud

This archive displays posts tagged as relevant to compounding pharmacies and fraud related to compounding pharmacies. You may also be interested in our pages:

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May 28, 2021

Erik Santos of Georgia was sentenced to more than 11 years in prison following his guilty plea on healthcare fraud charges.  Santos conspired with Florida compounding pharmacy Patient Care America and others to recruit Tricare beneficiaries to fill prescriptions for expensive, supposedly tailor-made, compounded medications that consisted of little more than common pain or scar creams, but came with price tags as high as $10,000-$15,000 per month.  The beneficiaries did not need the medications, which had little to no therapeutic value, and Santos secured the prescriptions by paying doctors, who had not actually seen the beneficiaries, to approve pre-printed prescriptions for large amounts of these medications.  Santos’s fraudulent referrals caused an actual loss to the Tricare program of approximately $12 million.  PCA pharmacy paid Santos over $7 million in prescription referral kickbacks.  In addition to the prison sentence, the Court imposed restitution in the amount of $11.8 million and entered a forfeiture judgement of approximately $7.6 million.  USAO SD FL

Catch of the Week: Dozens of Fraudsters Sentenced in Multimillion Dollar Compounding Pharmacy Fraud

Posted  04/30/21
compounding pharmacy drugs
On Thursday, an Alabama District Court Judge sentenced dozens of defendants to prison for participating in a massive conspiracy to swindle insurers for medically unnecessary compound drugs. The defendants included company executives and managers, a prescriber, billers, and sales representatives associated with Northside Pharmacy, which was doing business as Global Compounding Pharmacy (Global). According to the DOJ...

April 29, 2021

Over two dozen defendants who were part of an extensive prescription drug fraud scheme involving Alabama-based Northside Pharmacy d/b/a Global Compounding Pharmacy have been sentenced to prison.  The defendants included company executives and managers, prescribers, billers, and sales representatives who, between 2013 and 2016, billed insurers such as Medicare and TRICARE for massive quantities of medically unnecessary prescription drugs.  In just that short period of time, the defendants caused insurers to pay nearly $50 million in medically unnecessary claims, with more than $13 million arising from improper payments to prescribers, and more than $8.4 million for prescriptions written out to Global employees themselves.  USAO NDAL

March 24, 2021

Two men in Mississippi have been sentenced to 7 years in prison and ordered to pay over $16 million in restitution to Medicare, TRICARE, and Express Scripts, as well as forfeiture of close to $1 million, for their roles in a multimillion-dollar healthcare fraud scheme.  Dempsey Bryan Levi and Jeffrey Wayne Rollins, the operators of the Gardens Pharmacy, LLC, had previously admitted to soliciting and incentivizing recruiters to obtain prescriptions for highly reimbursed compounded medications, and soliciting and incentivizing doctors to authorize those prescriptions.  USAO SDMS

March 16, 2021

Jack Lee Stapleton and Jack Hunter Stapleton, the former owners of a Florida-based telemarketing company known as CV McDowell LLC or J&J Tel Marketing LLC (the Stapleton Entities), have agreed to pay at least $4 million to resolve a qui tam case by a former employee alleging violations of the False Claims Act.  According to whistleblower Dwayne Thornton, the Stapletons solicited prospective patients through telemarketing calls, convinced them to accept compounded drugs regardless of need, and then procured prescriptions and sent them to compounding pharmacies that agreed to pay the Stapletons half of all TRICARE reimbursements.  USAO MDFL

February 2, 2021

The owner of Mississippi-based Medworx Compounding and Custom Care Pharmacy, Marco Bisa Hawkins Moran, has been sentenced to ten years in prison and ordered to pay $34.3 million in fines and restitution following his guilty plea on charges related to a conspiracy to defraud TRICARE and other healthcare programs.  As part of the scheme, which resulted in the submission of $22.1 million in fraudulent claims, Moran and his co-conspirators adjusted prescription formulas to ensure the highest reimbursement, paid marketers and physicians kickbacks and bribes to obtain prescriptions for high-yield compounded medications without regard to medical necessity, and routinely waived and/or reduced the collection of copayments. USAO SD MS

Top Ten Financial and Healthcare Fraud Prison Sentences of 2020

Posted  01/27/21
Hands in handcuffs behind back of white man in business suit
Individuals involved in financial and healthcare fraud schemes face not just civil liability, but also criminal penalties – including prison time. In 2020, the Department of Justice obtained substantial prison sentences in a myriad of cases involving healthcare and financial frauds, many of which involved convictions of the type of fraudulent schemes that whistleblowers report. Whistleblowers play an essential role...

January 15, 2021

The co-owner of multiple compounding pharmacies and pharmaceutical distributors in Mississippi has been sentenced to 18 years in prison and ordered to pay over $287 million in restitution and over $56 million in forfeiture after pleading guilty to healthcare fraud and money laundering.  As part of his guilty plea, Wade Ashley Walters admitted to being the mastermind behind a four-year scheme that defrauded TRICARE and private health benefit programs of over $287 million.  To perpetuate the fraud, Walters and his co-conspirators solicited and paid recruiters to procure prescriptions for highly reimbursed compounded medications, solicited and paid physicians to authorize prescriptions for same, adjusted prescription formulas to ensure the highest reimbursement possible, and improperly waived or reduced mandatory beneficiary copayments.  USAO SDMS

July 23, 2020

Two pharmacists who were co-owners of Advantage Pharmacy in Mississippi have been sentenced to over 12 years in prison each and ordered to pay between $9 million and $29 million in civil monetary judgment, and between $185 million and $189 million in restitution for committing healthcare fraud.  According to the press release, Glenn Doyle Beach and Hope Thomley marketed, dispensed, and distributed compounded medications without regard to medical necessity, causing various health benefit programs, including TRICARE, to pay over $200 million in reimbursements.  Thomley’s husband, Randy Thomley, has been sentenced to 8 years in prison and ordered to pay judgment and restitution of $3.6 million each for his role in helping to recruit TRICARE beneficiaries.  USAO SDMS

June 25, 2020

George Philip Tompkins of Houston, Texas, the former owner of Piney Point Pharmacy, was sentenced to ten years in prison following his conviction on charges of healthcare fraud, unlawful kickbacks, money laundering, and wire fraud.  Tompkins billed $21.8 million to federal and state worker’s compensation programs for medically unnecessary compound gels and creams, paying kickbacks to generate prescriptions while claiming that the kickbacks were legitimate marketing expenses. Thompson was also ordered to pay restitution of $12.3 million. DOJ
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