December 17, 2020

Pharmacies, Providers Agree to Forfeiture, Restitution, Fines and Civil Penalties of More Than $60 Million

Three individuals and sixteen pharmacies pleaded guilty in federal court to charges of healthcare fraud, conspiracy to commit fraud, and conspiracy to violate the federal anti-kickback statutes between September 2013 and May 2018. The three individual defendants, residents of California and Nevada, conspired to execute health care fraud schemes that targeted patients that had undergone, or were to undergo, bariatric surgical procedures. Collectively, the defendants engaged in actions that resulted in misleading advertising associated with supplying what were described as nutritional shakes. By enlisting various patients to order the nutritional shakes, the defendants secured patients’ insurance information. In turn, the defendants solicited the patients to appeal to their respective physicians to prescribe what were described as High Yield (expensive) compounded medications. The defendants also manipulated the collection of co pays on various medications to make it appear that co pays were being collected when in fact they were not. The three defendants and the 16 corporations agreed to forfeiture, restitution, fines and civil penalties amounting to more than $60 million.