By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On October 19, 2018, the federal government filed suit against a Florida pharmacy for allegations of illegal kickback schemes involving industry marketers. The U.S. Attorney’s Office for the Middle District of Florida alleges that Oldsmar Pharmacy was involved in illegal schemes that resulted in the federal Tricare program paying more than $21 million in reimbursements for prescriptions and False Claims Act (FCA) violations.
Suit Filed on Behalf of The Defense Health Agency (DHA).
The federal government filed the suit on behalf of the U.S. Department of Defense, including its Defense Health Agency (DHA). The DHA administers the Tricare program, which provides health insurance for active duty military personnel, military retirees and their dependents.
The government is seeking treble damages, civil penalties and restitution, based on its claims that the pharmacy submitted claims to Tricare for reimbursement for prescriptions of costly compound medications. The government claims that they knew were fraudulent under the FCA because of the kickbacks paid to marketers.
On October 18, 2018, the U.S. Department of Justice (DOJ) released a press release announcing the involvement of three military members in the scheme as sales representatives for Centurion Compounding, Inc. All three were indicted for paying kickbacks to Tricare beneficiaries to obtain prescriptions for compounded medications. You can learn more about this in the section below.21
Click here to read the DOJ’s press release.
Former Whistleblower Suit.
The lawsuit against Oldsmar Pharmacy and company President, Larry Smith, stems from a whistleblower suit filed in 2015 by Jennifer Silva and Jessica Robertson, former employees, according to the complaint.
The schemes allegedly occurred between September 2014 and February 2015 by Smith and Oldsmar and different pharmacy services administration organizations.
Tricare Reimbursements and Kickback Schemes.
According to the complaint, Centurion Compounding Inc., hired sales representatives as independent contractors who marketed costly compound medications to Tricare beneficiaries. Patients recruited by the sales reps were directed to send their prescriptions to Centurion, which then directed them to Oldsmar pharmacy.
From November 2014 to February 2015, Tricare paid about $18 million for approximately 4,000 claims for compound prescriptions as part of the kickback scheme, according to the federal government. Oldsmar paid Centurion more than $6.1 million in kickbacks, some of which was distributed to the individual sales representatives involved.
Additionally, prosecutors claim that pharmacy President, Larry Smith, entered into a second kickback scheme with several marketing companies. These companies published online advertisements offering free consultations for pain creams via telemedicine, without ever seeing a physician in person. In return, Oldsmar Pharmacy paid a 41 percent kickback to the marketers, the complaint alleges.
Click here to read the complaint in full.
The suit brings forward false or fraudulent claims; recovery of payments made by mistake by Tricare; and unjust enrichment. To learn more, click here to read one of my prior blogs on a similar case.
Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.
The Health Law Firm represents pharmacists and pharmacies in DEA, DOH and FDA investigations, qui tam and whistleblower cases, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The Firm also represents both plaintiffs (whistle blowers or relators) and defendants in False Claims Act (whistle blower or qui tam) cases. The firm’s attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
Sources:
Hale. Nathan. “Fla. Pharmacy Hit With False Claims Suit Over Kickbacks.” Law360. (October 19, 2018). Web.
Stringini, Mary. “St. Pete doctor pleads guilty to receiving kickbacks, BMW in $5.3 million pharmacy conspiracy.” ABC Action News. (March 8, 2018). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.
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