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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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June 12, 2019

Lake Country Pharmacy and Compounding Center in Georgia, along with two of its principals, Chris and Carey Vaughan, have settled allegations filed by a whistleblower under the federal False Claims Act and Georgia False Medicaid Claims Act.  According to former pharmacist Chris Coleman, Lake Country submitted bills to Medicare, Medicaid, and TRICARE for compounded medications that were made from non-reimbursable bulk powders but billed as if they were made from reimbursable tablets.  Without admitting or denying these charges, Lake Country agreed to pay $365,000 and enter into an Integrity Agreement with the Department of Health and Human Services.  USAO MDGA

May 29, 2019

A doctor in South Carolina has agreed to pay $92,506.30 to settle allegations of accepting illegal payments from OK Compounding, LLC, in exchange for prescribing their pain creams to TRICARE patients.  The False Claims Act violations allegedly occurred between February and May 2013, and involved “medical director fees” paid to Dr. Jerry Back that were in reality, kickbacks.  This was the eighth kickback settlement in the Northern District of Oklahoma since the beginning of the year.  USAO NDOK

March 26, 2019

The owner and managing member of a Mississippi-based pharmacy has plead guilty to one count of conspiracy to commit health care fraud and one count of conspiracy to commit money laundering and tax evasion in connection with a massive $200 million compounding pharmacy scheme involving at least 12 individuals over four years. Glenn Doyle Beach, Jr. of Advantage Pharmacy admitted to marketing and formulating compounded medications for TRICARE patients without regard to medical necessity, falsifying paperwork to mislead auditors, and engaging in money laundering and tax evasion to conceal proceeds. He is scheduled to be sentenced in July. DOJ; USAO SDMS

February 27, 2019

The owner and operator of a drug marketing company has pleaded guilty for his role in a $200 million scheme to defraud TRICARE in one of the largest healthcare fraud cases said to come out of Mississippi. Between 2012 and 2016, Howard Randall Thomley of Advantage Marketing Professionals allegedly recruited TRICARE beneficiaries to accept millions of dollars of medically unnecessary compounded medications by paying them a percentage of prescription revenues. The prescriptions forms — signed by medical professionals who never saw the recruited beneficiaries — were then filled by a compounding pharmacy, Advantage Pharmacy, who paid Thomley a portion of the reimbursements. For his role in the scheme, Thomley now faces a maximum sentence of 10 years in federal prison at his sentencing in July. USAO SDMS

February 20, 2019

Hope Thomley of Hattiesburg, Mississippi, pleaded guilty for her role in a compounding pharmacy kickback scheme.  Thomley was the owner and operator of acompany that marketed for Advantage Pharmacy in Hattiesburg, and received 50% of Advantage's reimbursements.  Thomley admitted that she knew Advantage submitted false claims for payment to federal healthcare programs for medications that had not been prescribed by a doctor or were not medically necessary.  Between 2012 and 2016, health care benefit programs, including TRICARE, reimbursed Advantage Pharmacy and other pharmacies involved in the scheme at least $200 million. DOJ

February 14, 2019

Compounding pharmacy Vital Life Institute LLC, formerly known as AgeVital Pharmacy LLC, will pay $775,000 to resolve claims that the company and its principals paid kickbacks to third-party marketing companies to solicit prospective patients, regardless of the patients' needs.  The investigation was initiated by the filing of a qui tam complaint under the False Claims Act by Manfred Knopf, who received unwanted compounded medications from AgeVital that were billed to Medicare.  Mr. Knopf will receive $139,500 as a whistleblower reward.  DOJ

February 8, 2019

A Texas-based marketing company, One Source Healthcare Organization, and its owner, James Paul Adams, have agreed to pay $339,412.50 to resolve allegations that it violated the Anti-Kickback Statute in accepting illegal payments from a compounding pharmacy to market their drug. Because the payments resulted in false claims being paid by Medicare and TRICARE, they were also alleged to be in violation of the federal False Claims Act. Two men affiliated with the compounding pharmacy, Oklahoma-based OK Compounding, LLC, were previously indicted on similar charges. USAO NDOK

February 7, 2019

A former bus driver with the New York Metropolitan Transit Authority has been sentenced to 20 months in prison for defrauding the authority's health benefit plan of $2.8 million. Enver Kalaba, who was recruited into the scheme by former bus driver Christopher Frusci, worked on behalf of an unnamed company to pay bribes to fellow MTA employees in exchange for medically unnecessary prescription compounded medications. For each prescription for medications such as pain creams, scar creams, and metabolic supplements, Kalaba and Frusci paid $100. As part of his sentence, Kalaba must now forfeit $138,630 in fraudulent earnings and pay $2.9 million in restitution. Frusci is scheduled to be sentenced next month. USAO NJ

February 4, 2019

Compounding pharmacy Pentec Health, Inc., which sells a drug Proplete for nutrition support for patients with end stage renal disease, has agreed to pay $17 million to settle claims under the False Claims Act.  Pentec was alleged to bill federal healthcare programs for product wasted during the compounding of Proplete, and for Proplete that was not medically necessary or was not actually received by patients, routinely waiving patient copays and deductibles to induce the prescription of the drug.  Pentec also entered into a corporate integrity agreement and will be excluded from participation on federal healthcare programs.  The case was initiated by whistleblower Jean Brasher, a former employee of Pentec, who will receive an undisclosed share of the settlement. USAO EDPA

January 28, 2019

Ademola O. Adebayo, of Odessa, FL, was convicted for his role in a massive compounding pharmacy fraud scheme through which he submitted false and fraudulent claims for compounded drugs and other prescription medications that were not medically necessary, never provided, or both. The evidence established that in his role as the pharmacist at A to Z Pharmacy, now-defunct, Adebayo conspired to submit or cause the submission of claims that often amounted to several thousands of dollars for a single tube of pain or scar cream. When the fraud was uncovered, Adebayo became the straw owner of Havana Pharmacy & Discount in Miami, where Adebayo and his co-conspirators continued the fraud. Adebayo personally benefited from the fraud and received $1.5 million. DOJ

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