On Thursday, April 26th, the U.S. Department of Justice announced that the owner of a Florida pharmacy was sentenced to 15 years in prison for fraud and ordered to pay $54 million in restitution for his role in a massive scheme that impacted private insurance companies, Medicare and TRICARE.
This case is just one of many over the past year, resulting from the government’s increased scrutiny and investigation of compounding pharmacies, both in the state of Florida and elsewhere throughout the United States. Investigations have resulted in numerous arrests, guilty pleas and convictions. These investigations have focused on relationships between pharmacies, physicians and marketing companies and illegal activities under both the federal and Florida Anti-Kickback Statutes.
Nicholas A. Borgesano Jr., 45, of New Port Richey, Florida, president and owner of A to Z Pharmacy of New Port Richey and several other pharmacies in the state, paid kickbacks and bribes to physicians in exchange for prescriptions and patient identifying information. One physician signed prescriptions for patients he never saw. Borgesano also admitted that he and his co-conspirators manipulated billing codes in the reimbursement claims and submitted reimbursement claims for pharmaceutical ingredients they did not have. Click here to read more about the case.
Be advised that physicians, recruiters and pharmacy owners continue to be the target of ongoing investigations into fraudulent claims involving compounded medications. For a refresher on best practices for avoiding Medicare fraud and abuse, click here to download a print-friendly white paper from The Centers for Medicare & Medicaid Services.