December 21, 2016
On November 15, 2016, the U.S. Attorney’s Office Middle District of Florida announced that Lemon Bay Drugs North, Inc. and Brooksville Drugs, Inc. have agreed to pay $750,000 to the federal and state governments to resolve allegations that they violated the False Claims Act. Lemon Bay Drugs is a pharmacy operating in North Port, Florida, and Brooksville Drugs is a pharmacy located in Brooksville, Florida. Both pharmacies are managed by Benzer Pharmacy Holding LLC and owned by Alpesh Patel.
According to the November 15, 2016 press release, Lemon Bay Drugs and Brooksville Drugs provided Medicare and Medicaid patients with generic prescriptions, but charged the government programs for the brand name versions of the prescriptions. A former pharmacy technician from Lemon Bay Drugs alerted authorities of this alleged misconduct and filed a lawsuit under the qui tam provisions of the False Claims Act. The whistleblower claimed that the pharmacies knowingly submitted false claims by billing Medicare and Medicaid for certain drugs they could not have dispensed because they did not have sufficient inventory of those drugs. The whistleblower will receive $142,500 for her share of the recovery.
Although not every state has set up their own whistleblower program, these programs are being viewed as a tool for state and federal regulators to help enforce securities industry regulations and deter financial fraud. Since January 2009, the Justice Department, through their Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, has recovered a total of more than $31.6 billion through False Claims Act cases, with more than $19.2 billion of that amount recovered in cases involving fraud against federal health care programs.