Florida Pharmacy Owner Pleads Guilty For Role in $8.3 Million Medicare Fraud Scheme

Lawyer, Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On September 27, 2022, a Florida pharmacy owner pled guilty to conspiring to commit healthcare fraud in an $8.3 million scheme. The scheme involved securing orders for medically unnecessary prescriptions billed to Medicare and paying bribes and kickbacks, the Department of Justice (DOJ) announced. Read the DOJ’s press release here. Read the DOJ’s press release here.

The Fraudulent Scheme.

Michael Murphy allegedly invested in Cure Pharmacy in Jacksonville, Florida, and two other pharmacies participated in the Medicare program. From around November 2019 through March 2021, the government alleged, Murphy and his co-conspirators paid kickbacks and bribes to telemarketing companies to recruit Medicare beneficiaries to accept prescriptions for various medications. According to court documents, the medicines were mainly topical creams, which the beneficiaries usually did not want or need.

Additionally, they paid kickbacks and bribes to telemedicine companies that employed or contracted with physicians who signed the prescriptions. According to court documents, the physicians typically signed the prescriptions after a cursory telephone conversation or without contact with beneficiaries. After obtaining Medicare beneficiary information and the signed medications, the pharmacy owner and co-conspirators submitted claims to Medicare, sometimes through multiple pharmacies they owned and controlled in practice known as “recycling.”
In total, they were reimbursed $8.3 million by Medicare Part D.

The Repercussions of the Guilty Plea to Conspiracy to Commit Health Care Fraud.

Murphy pleaded guilty to one count of conspiracy to commit healthcare fraud. He faces a maximum of 10 years in prison. According to the DOJ, a federal district court judge will determine his actual sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Click here to read about a similar case involving a Florida pharmacy owner.

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’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, call (407) 331-6620 or toll-free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

American Health Law Association. “Pharmacy Owner Pleads Guilty in $8.3 Million Fraud Scheme.” AHLA Health Law Weekly. (September 30, 2022). Web.

“Pharmacy Owner Pleads Guilty in $8.3 Million Fraud Scheme.” Bloomburg Law. (September 30, 2022). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of 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 Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620. Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in the practice of health law. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

KeyWords: False Claims Act defense attorney, FCA legal counsel, FCA defense lawyer, Anti-Kickback Statute (AKS) defense attorney, FCA representation, legal representation violating False Claims Act, pharmaceutical fraud lawyer, compounding pharmacy attorney, fraudulent practices of pharmaceutical companies, FCA violations attorney, health care fraud representation, DEA defense representation,  health law defense attorney, health care fraud defense attorney, The Health Law Firm, representation for health care fraud investigations, compounding pharmacy lawyer, prescription reimbursement representation, pharmacy defense attorney, pharmacist defense lawyer, representation for pharmacies, representation for pharmacists, legal representation for health care facilities, representation for health care professionals, U.S. Department of Justice (DOJ) investigation representation, DOJ defense attorney, representation for DOJ matters, attorney reviews of The Health Law Firm, The Health Law Firm attorney reviews, defense of Medicare audits and investigations, Medicaid audits and investigations, pharmacy and pharmacists audits, defense of DEA investigations and subpoenas and audits, Medicaid audit defense lawyer, representation for DEA investigation, pharmacy defense lawyer

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

Florida Pharmacy Owner to Serve 15 Years in Prison for $100 Million Billing Fraud Scheme

George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On April 26, 2018, the owner of several Florida pharmacies was sentenced to 15 years in prison and ordered to give up $54.5 million in restitution. Nicholas A. Borgesano Jr., owner of A to Z Pharmacies, pled guilty to his role in a $100 million scheme involving bogus insurance reimbursements for prescription drugs.

He pled guilty in November to charges of conspiracy to commit health care fraud and conspiracy to engage in monetary transactions in property derived from specified unlawful activity, according to the order. Click here to read more.

Health Care Billing Fraud Schemes. 

According to prosecutors, Borgesano was at the center of an alleged scheme in which the pharmacy owner used his six stores to peddle prescription compound medications. He would then submit fraudulent reimbursement claims to Medicare, Tricare and private insurance companies.

Borgesano and his co-conspirators are accused of manipulating billing codes in the reimbursement claims and submit claims for pharmaceutical ingredients they didn’t even have. Additionally, he used one of his pharmacies in Florida as the hub of operations and paid his co-conspirators through shell companies, checks and the purchase of assets, prosecutors said.

From the pharmacy owner and his group of conspirators, the U.S. Department of Justice (DOJ) has seized $7.6 million worth of property, including several luxury vehicles and a 50-foot racing boat, the DOJ said. To read more about the co-conspirators, click here to read the press release issued by the DOJ.

To read the judgement in full click here.

The expensive prescription medications and creams involved in this case have been targeted by prosecutors in a handful of other Florida suits alleging Medicare and Tricare fraud by pharmacy owners and others. Click here to read one of my prior blogs involving a similar case.


Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in DEADOH and FDA investigations, qui tam and whistleblower cases, regulatory matters, licensing issues, litigationadministrative hearings, inspections and audits. 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:

Greene, Kat. “Pharmacy Owner Gets 15 Years For Role In $100M Scheme.” Law360. (April 27, 2018). Web.

Manning, Margie. “New Port Richey pharmacy owner sentenced in $100 million fraud scheme.” Tampa Bay Business Journal. (April 26, 2018). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2018 The Health Law Firm. All rights reserved.

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