New Port Richey Pharmacy Agrees to Pay Feds $2.2 Million in Health-Care Fraud Case
The U.S. Attorney’s Office accused the pharmacy of billing the federal government for prescriptions that were generated through kickbacks to patients and providers.
TAMPA – Trinity Medical Pharmacy and several of its principals have agreed to pay the U.S. about $2.24 million to settle allegations that TMP violated federal law when it knowingly billed government programs for claims generated by illegal kickbacks, according to the U.S. Attorney’s Office for the Middle District of Florida.
TMP also violated the False claims act by knowingly omitting material information from TMP’s application to become a certified Express Scripts provider. The claims resolved by the settlement are allegations only, and there has been no determination of liability, the U.S. attorney said.
The settlement relates to TMP’s marketing and sale of compounded medicine that should be uniquely tailored to an individual patient’s need and is often extremely expensive. Between 2013 and 2015, TMP, formerly located in New Port Richey, billed TRICARE seeking millions of dollars in reimbursement for compounded medicine. At the time, Krutika Patel was TMP’s president and chief executive officer, Devan Patel was the company’s chief operating officer, Jay Martinez was TMP’s national sales director, and Nicholas Petrillo was the national account director and top sales representative.
The U.S. alleged that TMP and these individuals knowingly sought reimbursement for compounded medicine claims generated through illegal kickbacks to patients and providers. The U.S. also alleged that TMP knowingly failed to disclose a material fact—COO Devan Patel’s previous felony conviction—when seeking to become an authorized provider with Express Scripts. Express Scripts is the pharmacy benefit manager for TRICARE and several carriers associated with the Federal Employees Health Benefits Program.
“Protecting TRICARE and other federal health-care programs from fraud is a priority of the U.S. Attorney’s Office,” said Maria Chapa Lopez, U.S. attorney for the Middle District of Florida. “Those who defraud TRICARE misappropriate money intended to provide quality health care to members of our military and their families. We will continue to protect those who serve our country.”
Said Special Agent in Charge John F. Khin, Southeast Field Office, “This settlement demonstrates the effectiveness of investigations by the Defense Criminal Investigative Service and our law enforcement partners to ensure that precious taxpayer dollars are not used for unjust enrichment by fraudulent providers. DCIS protects the integrity of DoD programs by rooting out fraud, waste, and abuse which negatively impacts critical programs such as TRICARE.”
David Spilker, special agent in charge, Veterans Administration Office of Inspector General, said, “The improper CHAMPVA billings made by Trinity Medical Pharmacy diverted funds intended for the care of Veterans who honorably served in the Armed Forces of the United State. The continued oversight of the companies that do business with VA, as shown in this investigation, safeguard the integrity of VA programs and funding.”
The government’s action in this matter illustrates the emphasis on combating health care fraud, and one of the most powerful tools in this effort is the False Claims Act, officials said.
This settlement resulted from a coordinated effort by the U.S. Attorney’s Office for the Middle District of Florida; the Defense Criminal Investigative Service; the U.S. Office of Personnel Management, Office of the Inspector General; and the Department of Veterans Affairs, Office of the Inspector General. Assistant United States Attorney Lindsay Saxe Griffin led the investigation.
U.S. Attorney | Crime | Health-Care Fraud | Tampabay News | Local News
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