By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On September 14, 2016, co-owners of a Maitland, Florida, compounding pharmacy agreed to pay $7.75 million to the federal government to resolve False Claims Act (FCA) allegations. QMedRx reached the settlement in connection with alleged fraudulent billing practices for services that weren’t eligible for reimbursement through federal health care programs, prosecutors said.
The U.S. attorney’s office for the Middle District of Florida sought penalties and fines for Andy Miller, Tracy Miller and the Healthmark Investment Trust, who are partial owners of QMedRx and allegedly participated in the fraud scheme.
According to prosecutors, from January 2013 to January 2014, QMedRx knowingly billed federal health care programs for prescriptions that weren’t qualified for reimbursement. Under the federal Anti-Kickback Statute, the exchange of money or goods for federal health care program referrals is illegal.
“The United States Attorney’s Office is committed to protecting TriCare and other federal health care programs from fraud,” U.S. Attorney A. Lee Bentley III said in a statement. “Those who violate the Anti-Kickback Statute to generate business will be held accountable.”
The Federal Government’s Ongoing Battle.
Unfortunately, these types of elaborate fraud schemes have been seen many times before.
For example, this case stemmed from an ongoing investigation to unearth improper claims submitted to the TriCare program, a health care program that provides benefits for United States military personnel.
To read more on this ongoing health care fraud investigation, click here.
At The Health Law Firm, we have experience with FCA, whistle-blower/qui tam cases and allegations, click here to read a press release from one of our cases in 2015.
Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.
The attorneys of The Health Law Firm represent pharmacies and pharmacists in defending investigations, defending False Claims Act and whistleblower cases, defending against actions by the Drug Enforcement Agency (DEA) and the Department of Health (DOH), and in licensing, regulatory and corporate matters. They also represent health care providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program. They represent companies in buying and selling health care businesses and prepare contracts.
For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.
Kang, Peter. “Fla. Pharmacy Owners to Pay $7.8M to Settle FCA Suit.” Law360. (September 14, 2016). Web.
Jacobson, Susan. “Feds reach deal on pharmacy fraud case.” Orlando Sentinel. (September 15, 2016). Print.
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 George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999. Copyright © 2016 The Health Law Firm. All rights reserved.