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Pharmaceutical Wholesaler ALERT: Manufacturer Targeting Wholesalers for Allegedly Exploiting Returns Process

A major pharmaceuticals manufacturer may be targeting wholesalers and other distributors who allegedly exploited the manufacturer's returns process. The manufacturer appears to be alleging that distributors fraudulently represented the source of certain drugs, or that they falsely represented the circumstances of their purchase of the drugs, in order to allegedly induce the manufacturer or their agent to accept them through its return goods program and pay out reimbursements in accordance...

Pharmacy ALERT: Aetna Sends Termination Notices to Medicare Part D Network Pharmacies Based on Billing for Lidocaine Creams and Other Topical Treatments

Aetna has sent out notices of termination to Medicare Part D Network pharmacies based on a recent guidance from the Centers for Medicare and Medicaid Services (CMS) and the Office of the Inspector General (OIG). In the guidance, CMS and the OIG do not recommend termination as the response to any indicia of these billing practices. With respect to compounding and specialty pharmacies, CMS specifically advises that "pharmacies that specialize...

NY Anesthesiologist Indicted in Telemedicine Healthcare Fraud Scheme

A New York anesthesiologist was indicted on July 9 for her participation in an alleged telemedicine conspiracy to submit fraudulent claims to Medicare, Medicare Part D, and private insurance plans. The physician was charged with one count of conspiracy to commit healthcare fraud. According to the indictment, the physician, along with other providers, participated in a fraudulent scheme to order and prescribe Durable Medical Equipment (DME) and prescription drugs through...

FDA Issues New Warning Letters to API Repackers

The Food and Drug Administration (FDA) recently issued warning letters to three repackers of Active Pharmaceutical Ingredients (API) for alleged violations of Current Good Manufacturing Practice (CGMP) requirements. The FDA's issuance of these warning letters, along with statements made in a press release dated July 2, 2019, indicate that the FDA is increasing its oversight of the global supply chain for pharmaceuticals and active pharmaceutical ingredients, and issuing warning letters...

Jury Finds Medical Marketing Company Owner Guilty of Medicare Fraud Scheme

In a follow up to last month's OIG fraud alert regarding genetic testing scams, a federal jury found the owner of a Tampa, Florida-area medical marketing company guilty for his role in an over $2.2 million Medicare fraud scheme involving the payment of kickbacks and bribes to medical clinics. The problematic payments were in exchange for the referral of DNA swabs, to the Miami-based lab, that were obtained from Medicare beneficiaries....