Healthcare Fraud & Abuse Review 2021

PHARMACY SERVICES

DA TE

ENTITY

FCA ALLEGATIONS

AMOUNT

A pharmacy and a pharmacy technician agreed to pay more than $1.5 million to resolve FCA and CSA allegations that they repeatedly dispensed controlled substances despite “red flags” for diversion and dispensed the oral fentanyl spray Subsys to patients who were not medically qualified to receive the drug. As part of the resolution, Irina Shlafshteyn surrendered her Missouri pharmacy technician license, is permanently enjoined from dispensing controlled substances or being employed by any establishment that does so and is excluded from participating in federal healthcare programs for 10 years. Olive Street terminated its enrollment in the Transmucosal Immediate Release Fentanyl Risk Evaluation and Mitigation Strategy Program (TIRF REMS) and is permanently enjoined from seeking re-enrollment. Olive Street also entered into a three-year CIA with HHS-OIG. 56 Pharmacy chain, its owners and related entities agreed to pay $4.6 million to resolve FCA allegations that they billed TRICARE for: (1) prescription drugs at higher than their U&C price to other patients; (2) medically unnecessary compound creams; and (3) claims tainted by kickbacks in the form of waived beneficiary co-pays and payments to marketers for arranging for doctors to send prescriptions to Curant. The settlement also resolves allegations that Curant failed to return overpayments to TRICARE after learning about them. 57 Two specialty pharmacies and their pharmacist owner agreed to pay $1 million to resolve FCA allegations that they submitted prior authorization requests to Medicare for a drug used to reverse the effects of opioid overdose that were not reviewed or signed by prescribing physicians. The settlement also resolves allegations that the pharmacies filled prescriptions for the drug without collecting or attempting to collect co-payments from Medicare beneficiaries, in violation of the AKS. 58 Pharmacy and its owner agreed to pay $1 million to resolve FCA allegations that they billed Medicare for medication that was never dispensed. As part of the resolution, the parties entered a CIA with HHS-OIG. 59

Olive Street Pharmacy, LLC; Irina Shlafshteyn

10/4/2021

$1.508 million

Curant, Inc.; Curant Health Georgia, LLC; Curant Health Florida, LLC; Patrick Dunham; Scott Zepp; Marc O’Connor; Pankajkumar Patel

$4.6 million

10/25/2021

Plymouth Towne Care Pharmacy, Inc. d/b/a People’s Drug Store; Shaska Pharmacy LLC d/b/a Ray’s Drugs; Riad "Ray” Zahr

12/8/2021

$1 million

LAN Apothecary, Inc.; Bachtu “Theresa” M. Phan

12/13/2021

$1 million

56 https://www.justice.gov/usao-edmo/pr/creve-coeur-pharmacy-and-owner-agree-pay-150780850-resolve-lawsuit-alleging-dispensing. 57 https://www.justice.gov/usao-ndga/pr/atlanta-pharmacy-pay-46-million-settle-false-claims-act-allegations-regarding-compound. 58 https://www.justice.gov/usao-ma/pr/pharmacist-and-two-pharmacies-agree-resolve-allegations-false-claims-anti-overdose-drug. 59 https://www.justice.gov/usao-edpa/pr/philadelphia-pharmacy-and-its-owner-agree-pay-1-million-resolve-false-claims-act.

NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 56

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