Insurance Fraud NEWS
Illinois med compounder charged with kickback scheme
October 10, 2017, Decatur, IL
John Christopher Lemley, owner of Decatur, IL-based Southern Compounding and Apotheca Supply, entered a plea agreement on charges that he conspired to defraud Tricare, Express Scripts, and OptumRX out of more than $10 million.
Lemley improperly contracted with Medworx Compounding, of which he held a 20% interest in, to refer prescriptions to Southern Compounding. Then, Lemley paid kickbacks to independent sales representatives as incentive to refer Tricare prescriptions, according to the U.S. Attorney’s office.
"This defendant took part in a conspiracy that employed improper contracts, kickbacks, mislabeled drugs, and prescription forgeries in order to bilk millions of dollars from the federal health insurance program meant for America's military members and their families,” said Jay Town, U.S. Attorney for the Northern District of Alabama, in a statement.
Lemley also sold misbranded OTC medications as prescription drugs and did not reverse claims on prescriptions he knew were forged, the government said.
In another case, Gino Cordisco, the former Vice President of Store Operations for Med-Fast Pharmacy in Aliquippa, PA, was charged with one count of conspiracy after he participated in a scheme to fill prescriptions for nursing homes with “recycled, unused drugs that were commingled with drug stocks on hand at Med-Fast’s Institutional Pharmacy”, according to a statement from the U.S. Attorney’s Office for the Western District of Pennsylvania.
Med-Fast Pharmacy, owner Douglas Kaleugher, and related entities agreed to pay the U.S. nearly $2.7 million to settle civil False Claims Act allegations, which according to the Attorney’s Office were violated “ by submitting claims to Medicare and Pennsylvania Medicaid that sought reimbursement for the retail-packaged version of diabetes testing strips, while actually supplying patients with cheaper mail-order-packaged version of the same strips.”
The civil settlement resolves allegations in two separate whistleblower lawsuits filed in federal court in Pittsburgh.
Source: Drug Topics