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:
February 3, 2020
Senthil Kumar Ramamurthy of Texas has been sentenced to 10 years in prison for participating in two fraud schemes that amounted to $9.6 million in losses by Medicare and TRICARE. In the first scheme, which ran for 10 months in 2014, Ramamurthy and his co-conspirators were paid millions of dollars by compounding pharmacies to get TRICARE beneficiaries to sign up for medically unnecessary compounded prescription drugs. To get beneficiaries to sign up, defendants had falsely represented that the drugs would be free, when in fact co-payments were required. In the second scheme, which ran from 2015 onward, Ramamurthy and his co-conspirators paid doctors to refer Medicare beneficiaries—without first examining them—for needless genetic cancer screening tests. Many of Ramamurthy's co-conspirators have plead guilty and face sentencing later this month. USAO SDFLDecember 19, 2019
Five individuals have been sentenced for their roles in a scheme to defraud TRICARE through the submission of false and fraudulent claims for compounded prescription pain creams. Marketing firm Centurion Compounding, Inc., owned by Frank Monte and Kimberley Anderson, entered into an agreement with LifeCare Pharmacy, owned by Carlos Mazariegos and Benjamin Nundy, to pay kickbacks to Dr. Anthony Baldizzi in exchange for him writing prescriptions for compounded creams marketed by Centurion to TRICARE beneficiaries. LifeCare billed health insurers, including TRICARE, more than $12.4 million for compounded cream prescriptions written by Baldizzi and marketed by Centurion, realizing a profit of more than $10 million, which it shared with Baldizzi, Monte, and Anderson. Centurion also caused TRICARE to be billed additional fraudulent amounts through one or more other pharmacies. Monte and Anderson of Centurion were sentenced to 2 years and 1.5 years, respectively, and Monte forfeited more than $3 million in property. Baldizzi was sentenced to 1 year in prison, ordered to forfeit $100,000, and will surrender his license to practice medicine. Mazariegos and Nundy of LifeCare were sentenced to 1 year in prison and 5 years probation, respectively, and paid over $12.8 million in restitution and forfeiture. USAO MD FLNovember 15, 2019
Compounding pharmacy Midwest Compounders, Inc., and its owner Troy DeLong, agreed to pay $205,000 to resolve allegations that they submitted false claims to Tricare for prescriptions that resulted from unlawful arrangements between the pharmacy and prescribers or marketers, or otherwise overbilled for medically unnecessary dosages or redundant active ingredients. The allegations were first made in a qui tam case filed by a whistleblower under the False Claims Act. USAO ND IowaNovember 8, 2019
In the eleventh settlement involving the multi-state OK Compounding Pharmacy fraud scheme, podiatrist Jonathan Moore of Kentucky has agreed to pay $65,404 for the role he played in defrauding federal healthcare programs. In exchange for illegal kickbacks disguised as “medical director fees,” Dr. Moore allegedly prescribed medically unnecessary compounded pain creams to patients, many of whom were insured by Medicare and TRICARE. USAO NDOKNovember 7, 2019
Compound drug ingredient supplier Fagron Holding USA LLC has agreed to pay over $22 million to resolve two qui tam suits involving three of Fagron’s wholly-owned subsidiaries. According to whistleblowers, Freedom Pharmaceuticals Inc. grossly inflated the price of active pharmaceutical ingredients used in compound prescriptions, causing pharmacy customers to submit false claims to TRICARE. Other allegations involved subsidiaries Pharmacy Services Inc. and B&B Pharmaceuticals Inc., which were accused of submitting false claims to federal healthcare programs, manipulating prescription drug pricing, paying kickbacks to physicians, and illegally waiving patient copays. DOJOctober 31, 2019
In the largest healthcare fraud case ever to come out of Mississippi, pharmacy owner Thomas Spell has been sentenced to 10 years in prison and ordered to pay over $243 million in restitution for knowingly defrauding TRICARE. Between 2014 and 2016, Spell and his co-conspirators had deviously marketed compounded medications based on their rate of reimbursement from TRICARE, paid illegal kickbacks to marketers in order to obtain prescriptions from TRICARE beneficiaries, and improperly waived mandatory copayments for TRICARE beneficiaries. USAO SDMSFlorida Pharma Whistleblower Case Results in FCA Settlement by Private Equity Firm
Posted 09/27/19
