By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On February 13, 2019, a federal judge turned down a Florida pharmacy’s motion to dismiss a $21 million False Claims Act (FCA) suit, but allowed its sister company out of the suit. The judge said Z Stat Medical LLC, which operates as Oldsmar Pharmacy and its owner, must face the government’s claims that it engaged in illegal kickback schemes to defraud Tricare. Oldsmar’s sister company, Stat Direct LLC, was dismissed from the lawsuit completely. There was no evidence it was also involved in the alleged misconduct, according to court documents.
The First Alleged Scheme.
The case was originally brought as a result of a whistleblower complaint that alleged two schemes to defraud Tricare. The first scheme was allegedly a deal between Oldsmar and Centurion Compounding Pharmacy. Centurion was alleged to have hired sales reps as independent contractors. The sales reps marketed costly compounded medications, usually creams for pain and scars, to Tricare beneficiaries. Patients recruited by the sales reps were told to send their prescriptions to Centurion, which then directed them to Oldsmar to fill. The sales representatives would then get part of the reimbursement profit, according to the complaint.
In total, Tricare was stated to have paid about $18 million for these bogus claims, and Oldsmar was alleged to have paid about $6.1 million in kickbacks in a little over a year, the suit says.
The Second Alleged Scheme.
The second alleged scheme involved companies that included Health Savings Solutions and Vici Marketing. Oldsmar allegedly worked with Vici Marketing and published online advertisements offering free consultations. Referrals were funneled through Health Savings Solutions for compounded pain creams. These prescriptions were written and filled, without a patient ever seeing a doctor in person, according to court documents.
According to the government, from September 2014 to February 2015, Oldsmar Pharmacy filed 700 prescription claims with Tricare based on referrals from Health Savings Solutions. In return, Oldsmar Pharmacy paid a 41 percent kickback to the marketers. This resulted in Tricare paying out about $3.4 million. Oldsmar made $5.5 million in payments to Health Savings Solutions, including three payments of about $1 million each, according to the complaint.
Click here to read the complaint in full.
Liable for False Claims.
Judge Hernandez Covington said the government pled the allegations sufficiently to keep Oldsmar and its owner in the case. The government has also satisfactorily alleged that Oldsmar’s owner has enough of an understanding of the Anti-Kickback Statutes (AKS) to have known better, according to the Judge.
While Oldsmar Pharmacy did return $19 million to Tricare, the FCA calls for treble damages Three times the amount), so the company can’t avoid litigation, the judge said, adding that she’ll deduct the $19 million from any final amount determined top be owed.
Click here to read the judge’s order in full.
To read about a case Judge Hernandez Covington made a similar ruling on dealing with a Florida Compounding Pharmacy’s FCA Suit, click here to read one of my prior blogs. (https://www.thehealthlawfirm.com/blog/posts/federal-judge-refuses-to-dismiss-florida-compounding-pharmacys-fca-suit.html)
Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.
The Health Law Firm represents pharmacists and pharmacies in DEA, DOH and FDA investigations, qui tam and whistleblower cases, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The firm’s attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
Sources:
Kass, Dani. “Pharmacy Must Face $21M Prescription Kickback Suit.” Law360. (February 13, 2019). Web.
“13 IN TAMPA CHARGED AS PART OF NATIONAL HEALTHCARE FRAUD TAKEDOWN.” Tampa Bay Reporter. (June 29, 2018). Web.
Hale, Nathan. “Feds Want FCA Suit Over $21M Kickback Scheme To Proceed.” Law360. (January 28, 2019). Web.
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.
KeyWords: False Claims Act defense attorney, FCA legal counsel, TRICARE false claims legal defense attorney, TRICARE physician representation, legal representation violating False Claims Act, pharmaceutical fraud lawyer, compounding pharmacy attorney, fraudulent practices of pharmaceutical companies, whistleblower lawyer, whistblower defense attorney, representation for FCA violations, financial interest in physician referrals, TRICARE fraud attorney, The Health Law Firm, representation for healthcare fraud investigations, conflict of interest in physician referrals, representation for compounding pharmacies, compounding pharmacy defense lawyer, prescription reimbursement representation, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) violations lawyer, representation for kickback allegations, representation for allegations of fraud, legal defense of military physicians, legal defense of TRICARE providers, FDA investigation attorney, representation for FDA investigations, DEA defense attorney, representation for DEA investigations against healthcare professionals, representation for DOH investigations, DOH investigation attorney, attorney reviews of The Health Law Firm, Veterans Administration (VA) physician defense attorney, The Health Law Firm attorney reviews, legal representation for pharmacies, legal representation for pharmacists, health law defense attorney, legal representation for health care professionals
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2019 The Health Law Firm. All rights reserved.
