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 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 EDPAJanuary 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. DOJNovember 16, 2018
A New Jersey-based doctor, Dr. Bernard Ogon, has been charged with participating in a compound pharmacy fraud that caused over $20 million in losses to health care benefit programs, including $3 million in losses to TRICARE. In exchange for a per-prescription payment, Ogon allegedly signed prescriptions that were pre-filled by telemedicine companies on behalf of patients he never saw. On multiple occasions, the prescriptions were for pain and scar creams that were not medically necessary, and were in fact exorbitantly expensive when made by a compound pharmacy. Ogon was also accused of writing prescriptions for patients in states that he was not licensed to practice in; if convicted, he faces a maximum of 10 years in prison. USAO NJOctober 22, 2018
A Kentucky-based medical equipment supplier has agreed to pay $5,254,912 to settle claims based on the False Claims Act that it defrauded many government insurers, including Kentucky Medicaid, Medicare, and CHAMPVA (under the Department of Veterans Affairs), by submitting fraudulent claims relating to certain compounded creams that it produced. According to the DOJ press release, in order to be properly reimbursed, Cooley Medical Equipment, Inc. was required to obtain prior authorization from Kentucky Medicaid and CHAMPVA before using certain powdered ingredients. Instead, Cooley claimed to use cream-based versions of the same ingredients, then submitted thousands of false claims to the insurers, and received millions of dollars in reimbursements. The company eventually came clean and self-disclosed to the US Attorney's Office, allowing it to pay a fine of 1.5 times instead of the usual 3 times loss suffered by the government. USAO EDKYOctober 18, 2018
Four individuals have pleaded guilty to conspiring to violate the Anti-Kickback Statute for a scheme that made payments to patient recruiters and a medical office assistant to find TRICARE beneficiaries to get prescriptions for compounded prescription pain cream, scar cream, and supplements from a doctor who had never seen the patients. In less than one year, the scheme generated over $10 million in compound prescriptions for over 100 TRICARE beneficiaries. E.D. Ark.Healthcare Fraud: it’s not just Medicare and Medicaid
Posted 10/17/18
