“No prescription equals false claims,” that was part of warning issued by PharMerica’s own auditor after finding that many of the company’s were sending out drugs without a written prescription. Last Friday’s false claims act suit filed by the Justice Department in Milwaukee comes as no surprise. New details show the pharmacy giant was warned as early as 2000 that it was shipping drugs without prescriptions.
Because about half of PharMerica’s sales are paid for by Medicare, violations are punishable under the federal False claims Act. That means the company may have to pay triple damages to the government or $11,000 for each drug invoice sent to Medicare without a valid prescription.
Pharmacies and nursing homes receive billions of dollars each year from Medicare. Unfortunately some healthcare providers cut corners to squeeze a few extra bucks out of the system. Because Medicare is funded by tax dollars, taxpayers are victims of these scams. If the allegations against PharMerica are true, patients may also be victims.
The complaint unsealed last Friday says PharMerica was shipping powerful narcotics to long term care facilities without a valid prescription on file. While the government is pursuing its losses against the pharmacy, the nursing homes receiving these drugs have some responsibility as well.
Allowing nursing home staff to drug patients without a doctor’s order is dangerous. We are unsure whether the nursing homes were simply to lazy to have their patients properly evaluated or if they were trying to save a few bucks on medical fees. Either way, ordering drugs such as morphine and oxycontin for patients without a doctor’s review is dangerous. This is especially true if the patient is already taking other medications (most nursing home patients take multiple prescription drugs).
The problems at PharMerica appear to date back at least a decade. A review by the DEA in 2000 found serious problems. A similar review by the company’s own internal auditors turned up the same problems 7 years later. It wasn’t until 2009 and 2010 that 3 whistleblowers finally came forward and filed claims under the False Claims Act. By doing so, they become eligible for a cash award of 15% or more of whatever the government collects. Since the company dispenses 44 million prescriptions annually, the damages (and the whistleblower’s award) could be huge.
[As we noted on Friday, the filing of a false claims complaint by the government does not mean the company is guilty of wrongdoing. At this point, the claims made in the government’s complaint are mere allegations. PharMerica has not yet filed an answer to the complaint.]
To qualify as a whistleblower, one must have non public, “original source” information about a fraud to taxpayers or a taxpayer funded program such as Medicare. If you wish to become a whistleblower and think you have a false claims case, give us a call. We represent whistleblowers and help them stop fraud and collect the largest award possible.
Mahany & Ertl – America’s Fraud Lawyers. Offices in Milwaukee, Wisconsin; Detroit, Michigan; Minneapolis, Minnesota; Portland, Maine and San Francisco, California. Services available in many jurisdictions.
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Posted by Brian Mahany, Esq.