At the close of last week, the United States Department of Justice (DOJ) announced that it had filed a lawsuit against PharMerica Corporation. The DOJ alleges that the company provided drugs without prescriptions, violating the Controlled Substances Act, and filing for payment from Medicare for the illegally dispensed drugs, violating the False Claims Act.
The government only became aware of PharMerica’s actions once a former employee of the company filed a complaint against the company in 2009. Jennifer Denk’s complaint was filed under the qui tam provision of the False Claims act. The act permits individuals to bring lawsuits against entities that knowingly defraud the government. Under the qui tam provision of the False Claims Act, individuals that pursue recovery on behalf of the government, informally known as whistleblowers, may share in any recovery made.
“The False Claims Act allows for the brave actions of whistleblowers to be rewarded by the government,” commented James Kauffman, an attorney with the Levin, Papantonio law firm who practices in the areas of whistleblower and False Claims Act litigation. “Often, without the actions of the individuals having the courage to come forward and report corruption, scams like these, that can cost taxpayers millions, would go unchecked.”
In this case, the defendant company, PharMerica, made a practice of issuing Schedule II drugs without a prescription, according to Court documents. Drugs, such as Oxycodone, morphine, and cocaine, are assigned to the Schedule II class due to their propensity for abuse without a physician’s administration. According to the DOJ’s release, nursing staff and pharmacists would issue Schedule II drugs without verifying that a physician had made an assessment that they were medically necessary.
“Facilities in situations similar to PharMerica’s will often put patients at risk before exposing the wrong they are committing against the government,” Mr. Kauffman continued. “The money fraudulently taken from the government aside, the risk to patients is too great to allow such behavior to continue.”
Each year, millions of dollars are recovered by the government against fraudulent chargers. Since its inception in 2009 the government’s Health Care Fraud Prevention and Enforcement Action Team (HEAT) has recovered over $10 billion dollars for health care fraud.