On December 15, 2014, a federal jury convicted the owner of a Maryland-based pharmacy chain of health care fraud for automatically submitting refills for prescription drugs to health care benefit programs such as Medicare and Medicaid without patients’ knowledge and consent. The automatically refilled medications were typically expensive HIV and cancer medications. In addition, claims for payment were not reversed when customers did not receive the medications. Some medications which were “refilled” but not actually delivered were restocked and reused to fill other prescriptions. The owner faces a maximum sentence of 10 years in prison and a mandatory two years in prison consecutive to any sentence imposed for aggravated identity theft, plus a $25,000 fine. The loss to the government insurance programs was estimated to be at least $2.5 million.
Frier Levitt provides legal counsel on various pharmacy and healthcare compliance issues and can assist your pharmacy in drafting Standard Operating Procedures (SOPs) on restocking drugs and processing automatic refills to ensure your Pharmacy’s practices avoid scrutiny. If you have been contacted by authorities regarding an investigation, contact Frier Levitt. We represent Pharmacies facing federal and state investigation and prosecution and can help you avoid criminal penalties.