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Oberheiden Attorneys

Federal Pharmacy Investigations At All-Time High

Categories: Anti-Kickback Issues

Federal Pharmacy Investigation Attorneys - Oberheiden & McMurrey, LLP
Dr. Nick Oberheiden, Esq.
www.federal-lawyer.com
Direct: (214) 469-9009
1-800-810-0259
Call Us on Weekends

As we have been advising our clients over the past years, federal agencies are demonstrating heightened and increasingly penetrative investigations into compound pharmacies.  In particular, the Department of Defense has stepped up its investigation into such pharmacies and their Tricare billings after realizing that the average compounded drug billed to Tricare cost approximately $3300.  Tricare paid $240 million for compounded drugs in February 2015.

Under the current federal administration, healthcare fraud has become a top priority for federal prosecutors, second only to the prosecution of violent crimes.  On January 21, 2016, nine compound pharmacies in Mississippi were raided by federal and state narcotics agents, who seized over $15 million in assets, including cash, boats, vehicles, and planes, from Mississippi, Alabama, Florida, and Utah.  The investigation involves the FBI, Department of Defense, U.S. Postal Service, IRS, U.S. Attorney’s Office, and Mississippi Bureau of Narcotics.

The agencies later confirmed, via The Wall Street Journal, that the raid was related to compound pain creams that had been billed to Tricare, Medicare, Medicaid, and private insurers.  In early February, at least one company being investigated, Opus RX LLC, filed for federal bankruptcy protection.  The investigation is continuing, but thus far the allegations include overbilling, automatic refills, sending more product than the patient ordered, and billing for products with limited or no medicinal value.

Such investigations often begin with an administrative subpoena, known as an OIG Subpoena.  If you have received an OIG Subpoena, other subpoena, or have received any type of notice that you may be under federal investigation, you should act quickly to retain lawyers that have mastered the complexity of the healthcare industry and the rules regarding compounding and federal billing, as well as understanding how to litigate and defend against unjust healthcare fraud allegations.

The attorneys of Oberheiden & McMurrey, LLP have the experience, the track record, and the staff to resolve investigations without recourse to criminal indictments. Our team of former federal prosecutors include the former chief coordinator for healthcare fraud at the Department of Justice (NDTX), team leader and chief leader of the Medicare Fraud Strike Force (NDTX), and other highly respected and experienced attorneys that have concluded dozens of healthcare fraud cases with no civil and no criminal liability for our clients.

  • Nick Oberheiden, Managing Partner, Healthcare Fraud Defense
  • Lynette S. Byrd, Former Federal Prosecutor, Department of Justice

Healthcare Fraud Defense (most recent only)

  • Investigation against Healthcare Provider (Department of Justice)
    Result: No civil or criminal liability, case dismissed.
  • Investigation against Healthcare Provider (Medicare Fraud)
    Result: No civil or criminal liability, case dismissed.
  • Investigation against Healthcare Provider (Department of Defense)
    Result: No civil or criminal liability, case dismissed.
  • Investigation against Healthcare Provider (OIG)
    Result: No civil or criminal liability, case dismissed.
  • Investigation against Healthcare Provider (Department of Labor)
    Result: No civil or criminal liability, case dismissed.
  • Investigation against Healthcare Provider (Department of Justice)
    Result: No civil or criminal liability, case dismissed.
  • Investigation against Healthcare Provider (S. Attorney’s Office)
    Result: No civil or criminal liability, case dismissed.
  • Investigation against Healthcare Provider ( Health & Human Serv)
    Result: No civil or criminal liability, case dismissed.
  • Investigation against Healthcare Provider (OIG)
    Result: No civil or criminal liability, case dismissed.
  • Investigation against Healthcare Provider (Department of Justice)
    Result: No civil or criminal liability, case dismissed.

Give us a call and benefit from our experience and reputation. Find out how a former chief healthcare prosecutor from the U.S. Attorney’s Office assesses your case.

This information has been prepared for informational purposes only and does not constitute legal advice. This information may constitute attorney advertising in some jurisdictions. Reading of this information does not create an attorney-client relationship. Prior results do not guarantee similar future outcomes. Oberheiden & McMurrey, LLP is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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