Pharma Fraud

December 14, 2017

Texas-based DaVita Rx LLC, a nationwide pharmacy that specializes in serving patients with severe kidney disease, agreed to pay $63.7 million to resolve charges of violating the False Claims Act by billing Medicare for prescription medications never shipped, shipped but subsequently returned, and that did not comply with requirements for documentation of proof of delivery, refill requests, or patient consent. The settlement also resolves allegations that DaVita paid financial inducements to Medicare beneficiaries in violation of the Anti-Kickback Statute. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by two former DaVita employees Patsy Gallian and Monique Jones. The whistleblowers will receive an award of $2.1 million from the proceeds of the government's recovery. DOJ

December 12, 2017

Med-Fast Pharmacy, Inc. agreed to pay roughly $2.7 million to resolve both criminal and civil charges of violating the False Claims Act relating to the conduct of Iserve Technologies, Inc., a company co-located with and operated out of Med-Fast, filling prescriptions for nursing homes with recycled unused drugs that were commingled with drug stocks on hand at Med-Fast’s Institutional Pharmacy. The settlement also resolves allegations that Med-Fast sought Medicare and Medicaid reimbursement for the retail-packaged version of diabetes testing strips while actually supplying patients with cheaper mail-order-packaged version of the same strips. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. The whistleblower will receive a yet-to-be-determined award from the proceeds of the government's recovery. DOJ (WDPA)

December 20th, 2017

California announced a $13.5 million multistate settlement with pharmaceutical company Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI) for its deceptive and misleading representation and off-label marketing of its prescription drugs. California will receive $857,000. The settlement resolves allegations that BIPI misled the public about the uses and efficacy of prescription drugs, including Micardis, Aggrenox, Atrovent, and Combivent. The settlement comes after a multistate investigation found that BIPI engaged in deceptive practices. BIPI represented that its prescription drugs had sponsorship, approval, characteristics, ingredients, uses and benefits that they did not have. For example, BIPI engaged in off-label marketing and promoted its drugs to treat life-threatening conditions, such as heart attacks, congestive heart failure, and strokes, without evidence to substantiate their claims. CA

November 30, 2017

Florida-based Express Plus Pharmacy, LLC and its owner Antonio Primo agreed to pay $170,000 to resolve allegations they violated the False Claims Act by submitting fraudulent claims to Tricare for compounded medications such as pain creams that were not reimbursable because they were not issued pursuant to valid physician-patient relationships, were issued after brief phone calls with patients that violated applicable law on telemedicine, were medically unnecessary, and/or were tainted by kickbacks to marketers.  DOJ (SDFL)

September 22, 2017

The Securities and Exchange Commission today filed fraud charges against Aegerion Pharmaceuticals for exaggerating how many new patients actually filled prescriptions for an expensive drug that was its sole source of revenue. Aegerion, now a subsidiary of Novelion Therapeutics, has agreed to pay a $4.1 million penalty to settle the charges that it misled investors on multiple occasions in 2013.  The SEC’s complaint alleges that Aegerion told investors that the number of unfilled prescriptions for Juxtapid was not material and the “vast majority” of patients receiving prescriptions ultimately purchased the drug.  The SEC alleges that Aegerion’s records reflect that it was actually around 50 percent of prescriptions that resulted in actual drug purchases. SEC

October 4, 2017

Med-Fast Pharmacy, Inc. and its owner Douglas Kaleugher agreed to pay roughly $2.7 million to settle charges of violating the False Claims Act by distributing and submitting claims to Medicare for medication that it had either recycled from long-term care facilities serviced by its institutional pharmacy, or that otherwise differed from the medications identified as part of the claims submitted to the government.  The government further alleged the company sought reimbursement for the retail-packaged version of diabetes testing strips, while actually supplying patients with cheaper mail-order-packaged version of the same strips.  The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act.  The whistleblowers will receive an award from the proceeds of the government's recovery. DOJ (WDPA)