Compound Pharmacy Fraud Defense Attorneys

Defending Compound Pharmacy Fraud Charges Across the US

Compounding pharmacies have been on the rise as many pharmacists see the need for personalized, patient-specific drugs.  Compounding allows pharmacists to reduce the dosage of medicines for children, engineer medicines to work around a patient’s allergy, and create creams instead of pills for those who have difficulty with oral medications.  However, as the usage of these compounds increases, so does the government’s attention to possible incidences of fraud.

Fraud is not only a serious civil allegation; it also may constitute a federal felony.  Monetary liabilities can be enormous, and the government may also seek prison time.  The possibility of being held accountable for Medicare, Medicaid, Tricare, and other healthcare fraud because of your compound pharmacy practice should caution you to invest your time and resources into a strategic and thoughtful defense plan with an attorney who is experienced in defending this type of case.

Oberheiden, P.C. is team of former federal prosecutors and experienced defense counsel. If you are subject to an OIG subpoena, contacted by agents, or a target of a government investigation, you should call 1-800-810-0259 immediately to speak with us.

We will assess your case for free. Find out what former federal prosecutors think about your case!

What Is Compounding Fraud?

U.S. Attorneys have been increasingly executing criminal search warrants in connection with compound pharmacies in the last few years. Obviously, falsified records and kickbacks are often raised as reasons for indictments in all types of healthcare fraud.  However, the most common fraud charges relating to compound pharmacies center on the ability of pharmacies to bill for each ingredient in a compound formulation. The government will often allege that ingredients were added to the compound that were not needed or did not benefit the patient, but were merely for the purpose of increasing the pharmacy’s remuneration.

In addition, the federal government will often file fraud charges for kickbacks, overbilling, billing for unnecessary products, providing automatic on-going refills, or for mass compounding or manufacturing compound drugs that are identical to commercially available alternatives.

What Are the Penalties?

Like most allegations of healthcare fraud and abuse, the government investigates pharmacy and compound pharmacy fraud under the False Claims Act and the general Healthcare Fraud Provision. Notably, this avenue gives the government the option to ask for reimbursements and fines (civil penalty) or to prosecute and indict responsible individuals in federal court (criminal penalties, imprisonment).

If found guilty, targets of investigations may be exposed to recoupment requests, non-payment of future claims, civil fines, exclusion from federal healthcare programs, treble damages, attorney fees, criminal fines, criminal indictment, or incarceration in a federal prison.

It is important to note that liability does not require a specific intent to violate the law; in fact, the government does not even need to prove actual knowledge of the wrongfulness of the transaction. The mere fact that wrong bills were submitted is enough to hold the company responsible.

What Happens In a Fraud Investigation?

Compound pharmacy fraud is investigated by the Office of Inspector General (OIG), the Department for Health and Human Services (HHS), the Department of Labor (DOL), the Department of Justice (DOJ), the Federal Bureau of Investigation (FBI), the Drug Enforcement Agency (DEA), and the Food and Drug Administration (FDA).

Many cases begin with the pharmacy receiving a subpoena issued by the Office of Inspector General. The subpoena will typically ask for the production of documents such as company records, financials, marketing agreements, physician relationships and the like. While such a request may appear harmless, the true danger with these subpoenas is that it is initially unclear if the investigation is civil or criminal in nature. An experienced OIG defense lawyer will often be able to tell from reading between the lines if the document production sought is for a civil or a criminal case.

In the alternative, agents from DEA or FTA or FBI show up at the door and ask to speak with employees or staff. Such request could be based on a presented search warrant or simply as part of a general inquiry. It is absolutely paramount to remain polite but to insist on the right to have an attorney present. Federal agents are trained to interview people and to gather information. Questions may appear innocent and general, but nonetheless the true background and the context of the questions remain unknown. Agents tend to ask questions, not to answer questions.

In either scenario, of which there are variations, it is important to call experienced attorneys such as the former healthcare prosecutors of the Oberheiden, P.C.. Many cases only turn into cases because of mistakes made in the initial stage of an investigation. Harmful answers given or documents volunteered without invocation of procedural and constitutional rights can barely be undone. Thus, don’t wait. When the government contacts you, call us first at 1-800-810-0259. It is your right.

Who Is Investigated?

Compound Pharmacy Fraud exposes providers and business owners alike. Statutes apply to any individual or business that directly or indirectly contracts with and is paid for services by the United States government.

• Business Owners
• CEOs & COOs
• Physician Owners
• Physician Referrals
• Pharmacists
• Employees & Marketers
• Financial Experts like CFO

Contact Oberheiden, P.C. online today.

Our Experience in the Pharmacy Industry

Our pharmacy experience is profound. The attorneys of Oberheiden, P.C. routinely advise healthcare providers, business owners, and physicians on virtually all aspects of healthcare law including but not limited to toxicology laboratories, DNA testing, surgical implants, hospitals, and surgery centers to name just a few.

Specifically with respect to pharmacies and compound pharmacies, Dr. Oberheiden and his team have advised pharmacy entities, pharmacy CEOs, CFOs, affiliated physicians, pharmacists, and senior management operating pharmacy businesses in Texas, Louisiana, Oklahoma, California, Florida, Michigan, Missouri, New York, New Jersey, and Ohio.

Our vast experience allows us to combine pharmacy law experience with trial and defense experience. For example, we have set up and assisted with:

• Pharmacy Kickback Defense
• Pharmacy HealthcareFraud Defense
• Pharmacy DEA Audit Assistance
• Pharmacy DEA Show Cause Preparation
• Pharmacy Diversion Conflict
• Pharmacy DEA Licensing Issues
• Purchases of State and DEA Licensing

Our attorneys have analyzed, reviewed, and defended hundreds of thousands billed pharmacy claims. Similarly, if you are accused of overbilling or kickbacks, you need lawyers that understand the legal requirements of the pharmacy industry as well as have the necessary court and government experience to get your case dismissed.

How To Get In Touch With Us

We pride ourselves with the fact that we are available for our clients. From the moment you call us, you will only talk to actual lawyers. In fact, you will not talk to secretaries and paralegals. You call and you will be immediately connected to us.

888-680-1745

Our Track Record (Fraud Defense)

• Defense of Medicare entity against investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare Fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of a healthcare services company against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged False Claims Act and Stark Law violations.
  Result: No civil or criminal liability, case dismissed.
• Defense of Medicare laboratory against investigations by the Department of Health and Human Services and the Office of Inspector General for alleged Healthcare Fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of nationally operating healthcare company against an investigation by the Department of Defense for alleged Tricare fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of healthcare marketing company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
  Result: No civil or criminal liability, case dismissed.
• Defense of a laboratory against an investigation by various branches of the federal government for alleged fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of physician owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
  Result: No civil or criminal liability, case dismissed.
• Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of a physician owned entity against an investigation by the Department of Justice for alleged fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged Stark Law violations.
  Result: No civil or criminal liability, case dismissed.
• Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations.
  Result: No civil or criminal liability, case dismissed.
• Defense of a physician owned entity against an investigation by various branches of the federal government for alleged False Claims Act, Stark Law, and Medicare violations.
  Result: No civil or criminal liability, case dismissed.
• Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of a physician owned entity against an investigation by the Department of Defense for alleged Tricare fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of a physician owned entity against an investigation by the Department of Justice for alleged Medicare Fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of physician owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
  Result: No civil or criminal liability, case dismissed.
• Defense of healthcare management organization against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged Medicare Fraud.
  Result: No civil or criminal liability, case dismissed.
• Defense of nationally operating laboratory against an investigation by the Office of Inspector General for alleged fraud.
  Result: No civil or criminal liability, case dismissed.