The U.S. Department of Justice U.S. Attorney’s Office Eastern District of Pennsylvania announced on March 17, 2020 that a Pennsylvania doctor who was alleged to have given out “Goodie Bags” of prescription drugs, including dangerous controlled drugs, has agreed to pay a total of $2.8 million in civil damages and penalties under the False Claims Act, Controlled Substances Act, and in civil forfeiture to settle a civil lawsuit charging the doctor of engaging in healthcare fraud and improperly distributing and dispensing controlled substances.
The federal lawsuit alleges that the Pennsylvania doctor, through his healthcare practice and employees, developed an unlawful scheme where his business dispensed prescription drugs, including controlled substances, to patients in what the staff referred to as “goodie bags.” The doctor allegedly dispensed the drugs to every patient whose insurance would cover the drugs he had in stock. The lawsuit alleges that the doctor dispensed the drugs for profit without any meaningful assessment of medical necessity or whether the drugs had a legitimate medical purpose.
For each “goodie bag” he dispensed, the doctor allegedly submitted claims for reimbursement falsely asserting that the drugs were medically necessary for the patient. The doctor also allegedly prescribed oxycodone to “pill-seeking” patients in exchange for submitting excessive claims to patients’ insurance, including Medicare, for medically unnecessary prescription drugs and for services not rendered. The federal filing states that the doctor also pleaded guilty to criminal charges on January 24, 2020 and admitted to these facts in court. The doctor reportedly agreed to pay $3.5 million in criminal restitution.
The settlement also permanently prevents the doctor from prescribing, distributing, or dispensing any controlled substances in the future and prevents the doctor from ever seeking another controlled substance registration from the Drug Enforcement Administration. The doctor will be excluded from Medicare and Medicaid participation for a 20-year period.
The Special Agent in Charge of the FBI’s Philadelphia Division stated in reference to the civil settlement, “[The doctor] pushed unnecessary pills on his patients and doled out opioids to addicts. All the while, he was billing Medicare and insurance companies for it and making multiple millions. It’s a gross violation of both medical ethics and federal law. Alongside the criminal case, these civil actions should help hammer home to the medical community that health care fraud is a crime that truly doesn’t pay.”
If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
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