As part of the criminal resolution, Insys agreed to a detailed statement of facts outlining its criminal conduct with respect to the illegal marketing of Subsys. Insys will enter into a five-year deferred prosecution agreement with the government, while Insys’s operating subsidiary will plead guilty to five counts of mail fraud pursuant to the plea agreement that will be filed in the District of Massachusetts. According to the terms of the criminal resolution, Insys will pay a criminal fine of $2 million and forfeiture of $28 million. The Court has not yet scheduled the plea hearing. Last month, five former Insys executives were convicted after trial of racketeering conspiracy in connection with the marketing of Subsys. In total, eight company executives have now been convicted in Boston for crimes relating to the illegal marketing of Subsys.
Nabil Fakih, a licensed pharmacist, Michigan Board of Pharmacy member, and owner of a Dearborn Heights drug store, was charged with healthcare and wire fraud and indicted by a grand jury. The Indictment accused Fakih of wrongfully taking millions of United States dollars from Medicare, Medicaid and Blue Cross Blue Shield (BCBS), dating back to 2011.
According to the indictment, Fakih is accused of falsely submitting claims on behalf of Dial Drugs. He was reported to be overbilling Medicaid and Medicare by $569,670 while overcharging BCBS by $558,079.
Fakih and others billed insurance companies for prescription drugs such as the antipsychotic medication, clozapine, and the sedative alprazolam. Claims for these drugs were on behalf of people who had died prior to the claimed date of delivery. This is according to government allegations.
Initially, Holly Blakely was charged in a 30-count indictment. This allegedly means that she paid more than $400,000 in bribes and kickbacks to clinicians for prescribing compounded medications. Compound medication is basically personalized medications produced in order to fit an individual’s exact medical needs. In this case, these compound medications, in particular, were designed to ease pain, but the people these were being given to did not require them.
Blakely confessed that she worked with two compounding pharmacies in order to push prescriptions for compound drugs. The pharmacies would then submit claims to health plans such as Tricare. In exchange for her part of the fraud, Blakely was paid $1.15 million.
The pharmaceutical industry in Pasadena is much like the rest of the United States. There are certainly an influx of individuals who receive Medicare using these services for particular ailments and diseases that accompany being older than 65 years old. However, a local Pasadena pharmacy, Akhtamar Pharmacy, was abusing the Medicare funds provided for those particular individuals. Although the pharmacy owner did not act alone, she was able to steal $1.3 million dollars from the Medicare system.
Pasadena Pharmacy Owner Convicted for Medicare Fraud
Although the pharmaceutical industry is driven by a purpose to help those who need medication, it can also be a place for fraudulent acts to occur. With so much paperwork to be completed, many individuals find themselves taking advantage of the system by falsifying numbers or providing inaccurate invoices. Unfortunately, this was the case in a Pasadena pharmacy. A 39-year-old pharmacy owner, Tamar Tatarian, was convicted on one count of healthcare fraud and two counts of wire fraud at Akhtamar Pharmacy in Pasadena. It is believed that she committed the fraudulent acts which amounted to $1.3 million dollars in total.
The settlement resolves allegations that, between 2006 and 2008, Abbott knowingly paid kickbacks to physicians in order to induce TriCor® prescriptions. Abbott, through its sales representatives, allegedly provided physicians with improper gift baskets, gift cards, and other items to induce prescriptions of TriCor®. Abbott also engaged health care providers for consulting services and speaking engagements, where one purpose of the remuneration for the programs was to induce or reward physicians for TriCor® prescriptions. As a result of the $25 million settlement, the federal government will receive $23.2 million, and state Medicaid programs will receive $1.8 million.
This settlement resolves allegations in a lawsuit filed in the Eastern District of Pennsylvania by Amy Bergman, a former Abbott sales representative, under the qui tam, or whistleblower, provisions of the False Claims Act. The qui tam provisions permit private parties to sue for false claims on behalf of the government and to receive a share of any recovery. Ms. Bergman will receive $6.5 million as her share of the recovery in the case. Attorneys Marc Raspanti, Pam Brecht, Mike Morse and Bob Nicholson of Pennsylvania represented Ms. Bergman.
The United States Department of Justice and the New York Attorney General have
reached a $10 million settlement in a newly unsealed health care fraud case against Sorkin’s Rx, Ltd.
a/k/a CareMed Pharmaceutical Services (“CareMed”), a national specialty pharmacy based in Nassau
County, New York. Continue reading