Compound pharmacies specializing in customized prescriptions to meet the unique needs of patients are growing in popularity. Minneapolis is home to several of these specialty pharmacies.
If you offer compounding services in your establishment, you may be at risk of pharmacy fraud charges. You might even be charged with fraud on the federal level, increasing your risk of an unfavorable outcome.
What are some examples of compound pharmacy fraud?
An investigation into possible compound pharmacy fraud generally focuses on specific activities. For example, the authorities might suspect a pharmacy of intentionally defrauding federal insurance programs like Medicaid. Other examples include:
- Making compounds that are identical to commercially available product
- Overbilling patients, insurers and federal insurance programs
- Billing patients and insurers for unnecessary compounds
- Offering kickbacks to healthcare associates (doctors, chiropractors, etc.) in exchange for referrals
- Charging for each ingredient that is used to create a single compound
- Auto-refilling compound prescriptions without authorization
- Intentionally mislabeling compounded prescription medications
A conviction for compounding pharmacy fraud can lead to life-changing penalties. In 2017, federal prosecutors charged a compound pharmacy owner with conspiracy to defraud a federal insurer out of more than $10 million.
The parties immediately entered a plea agreement requiring the owner to release $918,234 and a luxury auto bought with criminally obtained proceeds. In 2018, the federal judge assigned to the case sentenced the pharmacy owner to a five-year prison term.
An arrest on any pharmacy fraud charge requires an immediate response, especially if an allegation of defrauding the government arises. If you begin working on your defense right away, you will have a better chance of improving your situation.
For example, you could overcome the charges, have them reduced or perhaps arrange a plea deal imposing the least harsh consequences.