Last week the United States government filed a False Claims Act complaint against a pair of compounding pharmacies in Jacksonville, Florida for allegedly attempting to defraud Medicare and TRICARE.
Federal prosecutors say the two compounding pharmacies included a certain drug in topical creams that was not prescribed nor likely even effective in order to bill government health care programs for the drug, thereby inflating reimbursements. The drug in question is commonly prescribed for psychiatric disorders, and prosecutors say the two compounding pharmacies included it into topical medications meant for pain relief.
In addition to allegedly improperly including unprescribed drugs in formulations, Federal prosecutors say the two compounding pharmacies illegally waived patient copays on a regular basis. Though copayments may be waived in some circumstances, prosecutors say the compounding pharmacies did so as a matter of course and not after an investigation into whether such a waiver was warranted.
The Federal government took on the action after it was filed under the qui tam provision of the False Claims Act (a/k/a the “Lincoln Law”). Per the provision, a whistleblower may institute the action and turn it over to Federal prosecutors should the prosecutors feel the complaint has merit.
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