Pharmaceuticals

Here’s a selection of recent healthcare frauds from New Jersey. On April 17, John Sher of Margate was sentenced to 37 months in prison and ordered to pay $2.77 million in restitution and $327,987 in forfeiture for defrauding New Jersey state and local health benefits programs and other insurers. Sher and a co-conspirator recruited state…

Rivkin Radler’s Michael Sirignano authored an article for the March 2 issue of the New York Law Journal entitled “Healthcare Fraud Tops DOJ’s Annual False Claims Act Report – Again!” The article discussed a report issued by the U.S. Department of Justice detailing the settlements and judgments it obtained under the federal False…

On February 17, Daniel Russo, a Long Island resident, pleaded guilty in federal court in Brooklyn to multiple charges in connection with illegally distributing oxycodone. Russo faces decades in federal prison when he is sentenced.

Russo owned and operated Russo’s Pharmacy in Far Rockaway, Queens. From 2011 to 2014, he filled thousands of fraudulent prescriptions…

For those who just can’t get enough fraud, here are some of the “leftovers” from this edition of Fraud Week that your editor thought noteworthy.

Read about a pharmacy biller’s fake copay assistance scheme:

https://www.justice.gov/usao-edmi/pr/woman-convicted-billing-claims-part-65-million-pharmaceutical-coupon-fraud

Genetic testing kickback schemes

In TX: https://www.justice.gov/opa/pr/laboratory-owners-and-executives-charged-health-care-kickback-scheme

In FL: https://www.justice.gov/opa/pr/ocenture-llc-and-carelumina-llc-settle-allegations-false-claims-unnecessary-genetic-testing

And here’s a big one in GA: https://www.justice.gov/opa/pr/lab-owner-convicted-463-million-genetic-testing-scheme-defraud-medicare

DME kickback…

In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Geoffrey Kaiser and Jeffrey Ehrhardt will present “A Survey of OIG’s 2022 Advisory Opinions: What They Could Mean for Your Organization.” Jeff and Jeff will:

  • Discuss select Advisory Opinions from last year on a variety of topics, including use of
…

On November 9, the Pharmaceutical Coalition for Patient Access (PCPA) filed an action against the U.S. Department of Health and Human Services (HHS) after HHS’s Office of Inspector General (OIG) determined that a proposed patient assistance model posed more than a minimal risk of fraud, waste, and abuse under the federal Anti-Kickback Statute (AKS). PCPA…

A Suffolk County, New York court held on November 16 that White’s Apothecary in East Hampton was not negligent when it filled a physician’s opioid and benzodiazepine prescriptions as ordered. The plaintiff had claimed that the pharmacy should be liable for filling “excessive and dangerous doses” of oxycodone and Carisoprodol, a muscle relaxant, despite a…

The U.S. Department of Justice (DOJ) announced on November 16 that two pharmacy owners from Forest Hills, New York have pleaded guilty to conspiracy to commit money laundering through submission of fraudulent claims to Medicare during the COVID-19 pandemic. The co-conspirators owned over a dozen pharmacies in the New York area, through which they submitted…

Federal and state enforcement activity involving pharmacy fraud tops the list of categories in this edition of Rivkin Rounds’ Fraud Week. We’ll list just a sampling of cases.

On October 19, the U.S. Department of Justice (DOJ) announced that Jerry May Keepers of Kingswood, Texas was sentenced to 36 months of supervised probation for writing…

On October 7, the U.S. Attorney’s Office for the District of New Jersey announced that a former physician pleaded guilty to conspiring to wrongfully disclose patients’ protected health information to a pharmaceutical sales representative. Frank Alario, who had had numerous offices in New Jersey, Manhattan and Florida, admitted to criminal HIPAA violations in connection with…