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Apr 21, 2021 by |

Los Angeles Whistleblower Attorney: Pharmacist Kickbacks For Prescriptions Alleged

ATTORNEY NEWSLETTER

Unlawful Kickbacks For Drug Prescriptions Alleged

Luxury Goods, A New Car, And Cash Allegedly Used As Bribes

Expensive Medications Neither Necessary Nor Dispensed

Kickbacks for medical services and medications are against the law.  Anti-Kickback Statute, 42 U.S.C. § 1320a-7b. When the underlying services or drugs are paid for by government programs, the conduct also constitutes a violation of the False Claims Act.  31 U.S.C. §§ 3729 et seq.  In addition to illegal bribes or kickbacks for medications and referrals, other types of Medicare/Medicaid fraud include overbilling, upcoding, use of ineligible personnel to perform procedure (while billing for qualified personnel), performing unnecessary procedures or processing unnecessary admissions, selling unapproved drugs or devices, false certifications and eligibility records, or billing for services that were never provided.  Individuals with knowledge of illegal kickbacks can be rewarded for bringing suit against the offending companies who defraud these programs.  The suit is initiated by filing complaints known as “qui tam” complaints..  31 U.S.C. § 3730(b).  If you have credible information of illegal kickbacks or other healthcare fraud here in Los Angeles County or elsewhere in California, call us today at (415)441-8669 and we can help.

Pharmacist Accused of Illegal Kickbacks

In a recent announcement by the Department of Justice,[1] criminal charges and civil allegations under the False Claims Act and the Anti-Kickback Statute have been brought against a pharmacist who allegedly conspired to commit health care fraud and to pay kickbacks and bribes to customers for expensive prescription orders in connection with more than $4 million in Medicare and Medicaid reimbursements.  According to the government, the pharmacist submitted bills to Medicare and Medicaid for expensive prescription drugs that were not eligible for reimbursement because, among other reasons, they were not needed or not dispensed.  The pharmacist also allegedly conspired to pay kickbacks and bribes to customers to convince them to fill prescriptions at his pharmacies, and to pay customers cash in exchange for the ability to bill Medicare and Medicaid for over-the-counter health care-related products on their behalf.   As an example, according to the government’s announcement, the defendant allegedly wired nearly $100,000 from the pharmacy’s bank accounts to an automobile dealership to pay for a luxury car in exchange for prescriptions. Investigators conducted a search warrant at the pharmacist’s home at the time of his arrest and seized a luxury automobile worth over $250,000, as well as cash and luxury goods.  The owner of the pharmacy has been charged with conspiracy to commit health care fraud, conspiracy to defraud the United States by paying kickbacks and bribes in connection with the provision of health care services, and unlawfully spending the proceeds of his fraud.   He also faces civil damages, fines, and penalties.  The case is pending and there has been no finding of criminal or civil misconduct at this point.

Rewards and Protections For Blowing Whistle

The government did not announce the source of its information in announcing the charges in this case.  Often an insider such as an employee or former employee has information of these types of allegations of fraudulent conduct by a healthcare provide.  Employed persons are protected from employer retaliation for bringing false claims qui tam cases. 31 U.S.C. § 3730(h).  If you are fired because you brought any fraud to light, you can fight back under both the federal and State statutes.  You may be entitled to sue your employer and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2) (federal); Cal. Gov’t Code § 12653(b)(California). Our whistleblower attorneys can represent you in any action for retaliation as well as represent you in your underlying whistleblower application.

Contact Us

Ingrid M. Evans and our other Los Angeles County whistleblower attorneys represents individuals with original information of fraud against the government particularly under its Medicare and Medicaid programs.  Ingrid and the other whistleblower attorneys can be reached at (415) 441-8669, or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>.  The Los Angeles attorneys also handle bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program. 

[1] Evans Law Firm, Inc. was not involved in these cases in any way.

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