Tricare Compound Pharmacy and Prescription Fraud: Is It Time to Consult Experienced Attorneys?
Tricare Compound Pharmacy Fraud Defense Lawyers
Compound pharmacy fraud remains a serious enforcement focus. Pharmacy owners, health care marketers, and physicians engaged in compound prescriptions (or related telemedicine consultations) between the years of 2014-2016 must expect new waves of investigations and indictments.
Oberheiden, P.C. is a team of former Department of Justice prosecutors and criminal defense attorneys with significant experience and success in compound fraud investigations.
If you are accused of Tricare fraud, workers’ compensation fraud, prescription fraud, or similar health care offenses in connection with compound prescriptions, you should immediately contact one of our former prosecutors and defense lawyers for a free and confidential consultation.
The Oberheiden, P.C. Difference
Oberheiden, P.C. is a health care fraud defense firm mostly known for its forceful trial and negotiation practice. Our attorneys are former Department of Justice officials, former prosecutors from various U.S. Attorneys’ Offices, and some of the country’s most recognized criminal defense attorneys.
Our experience includes:
- Dismissal of state and federal indictments
- More than 70 years of Department of Justice experience
- More than 1,000 health care fraud investigations
- More than 1,000 grand jury investigations
- More than 500 criminal trials
Our attorneys have successfully represented physicians, marketers, and pharmacy owners against Tricare fraud accusations and Anti-Kickback violations for years, in virtually all parts of the United States. Don’t hesitate to contact us if you are concerned about your role or if you are under investigation. As we have for so many other clients, we will find a way to protect you.
What Are the Allegations?
Compound pharmacy and Tricare fraud investigations have dominated the news for years. Nonetheless, recent indictments in Texas, Oklahoma, Alabama, Florida, Ohio, Georgia, South Carolina, Colorado, Louisiana, New York, and New Jersey show that the federal government has not slowed down in its efforts to criminally prosecute alleged fraud schemes.
Federal prosecutors argue that pharmacy owners and health care marketers criminally conspired with prescribing physicians in an effort to unlawfully benefit from loopholes in the Tricare health care system. The government takes the position that most, if not all of the compound prescriptions for military members and injured workers were medically unnecessary and thereby fraudulent.
Looking more closely underneath the triangular relationship between compound pharmacies, physicians, and connecting marketers, various indictments have revealed alleged bribery and kickbacks designed to incentivize medical professionals to prescribe expensive compounds irrespective of their medical effectiveness or patient’s need.
In this context, it is important to remember that payments for business development must not be made to 1099 contractors and percentage-based commissions for bringing in governmental business constitutes a federal felony—unless payments were made to bona fide employees on a fixed salary basis.
In some cases, physicians are said to have neglected their obligations under the Controlled Substances Act by prescribing compound involving Schedule II and Schedule III drugs without appropriately establishing a doctor-patient relationship first— exposing these physicians to revocations of their medical license and their DEA privileges, malpractice suits, and criminal charges.
What Are the Charges?
Compound fraud cases are typically charged as a federal criminal health care fraud conspiracy pursuant to 18 U.S.C. 1347 and 18 U.S.C. 1349, often also involving mail fraud (18 U.S.C. 1341) and wire fraud (18 U.S.C. 1343), two additional federal felonies.
In this context, a criminal conspiracy means that two or more persons have combined, or mutually agreed, to do something illegal. The government must prove beyond a reasonable doubt that:
- Two or more persons agreed to try to accomplish a common and unlawful plan, as charged in the indictment; and
- That the defendant knew the unlawful purpose of the agreement and joined in it willfully, that is, with the intent to further the unlawful purpose.
The basic idea behind a conspiracy is that everyone contributed “something” to the success of the fraud scheme. The law does not require to have known the details of the scheme, nor is it necessary that all co-defendants within a conspiracy even know each other or ever had any communications with each other. Each conspirator connects the overall conspiracy offense to and with another conspirator.
Additionally, most prosecutors add mail and wire fraud charges to the indictment arguing that each submission, whether through U.S. mail or electronically, of a fraudulent prescription constitutes a separate criminal offense.
What Are Potential Penalties?
All offenses described constitute federal felonies. Depending on the fraud amount and a plethora of other factors, penalties in compound prescription fraud cases range from zero to twenty years and more in prison. If convicted or if a decision is made to plea guilty, defendants must expect all of the following consequences.
- Criminal Felony Charges
- Incarceration in Federal Prison
- Civil and Criminal Fines
- Asset Forfeiture
- Asset Seizure
- License Revocation
- Exclusion from Federal Programs
Don’t let this happen to you. Experienced attorneys are standing by to address your concerns and to navigate you through the process of an investigation or criminal case. Call today to speak to former federal prosecutors and attorneys with a track record of successful outcomes in compound cases.
Why Clients Trust Oberheiden, P.C.
Oberheiden, P.C. has successfully defended health care providers and business owners across the United States against health care fraud allegations involving the Anti-Kickback Statute, Tricare Fraud, workers compensation charges, DOL pharmacy fraud, pharmacy investigations, mail fraud, wire fraud, tax fraud, and money laundering.
Is It Time to Seek Counsel?
Surround yourself with experienced attorneys with a proven track record in health care fraud cases. The sooner you contact our attorneys, the better we can help you. Ducking in and remaining passive are not among the promising defense strategies to escape government scrutiny.
Kickback and health care fraud allegations in the context of compound scripts are being investigated by various branches of the federal government, often as part of so-called national health care fraud crackdowns. Involved are the Department of Defense (DOD), the Office of Inspector General (OIG), the Department of Health and Human Services (HHS), the U.S. Postal Inspection Service (USPIS), the Federal Bureau of Investigation (FBI), the Department of Justice (DOJ), and the Drug Enforcement Administration (DEA).
These are some of the common indications that you should seek counsel immediately.
- Federal Agents Want to Speak to You
- Someone You Know Was Contacted by the Government
- Someone You Worked With Was Arrested
- You Received a Subpoena
- You Were Arrested
- The Government Raided the Pharmacy
- You Were Paid a Commission (20-60%) for Your Compound Marketing
- Physicians: You Prescribed More than 100 Compounds
- Marketers: You Made More than $ 100,000 in Commissions
- Pharmacies: You Filled More than $ 500,000 in Compounds
Our clients are advised and represented by the former chief for health care fraud at the U.S. Attorney’s Office, former Assistant United States Attorneys (AUSA), former Special Assistant United States Attorneys (SAUSA), former Department of Justice Trial Attorneys, the former Deputy Chief of the Trial Section at the U.S. Attorney’s Office, and other lawyers with specific experience in health care law and health care fraud defense.
Who Will Help Me?
Oberheiden, P.C. does not utilize junior lawyers or paralegals. In order to save our clients’ time and budget, only senior lawyers (e.g. former federal prosecutors, experienced defense counsel) work on the cases of accepted clients.
If you are being investigated for potential involvement in compound referrals, you should immediately seek professional guidance. The experienced attorneys of Oberheiden, P.C. offer free and confidential consultations, including on weekends, to discuss your situation and to find a way to avoid or fight criminal charges.