Pharmacies pay $750K over fraud allegations

A pair of pharmacies have paid the federal government $750,000 to resolve claims that the entities fraudulently billed Medicare and Medicaid for brand-name prescription medications, but dispensed less-costly generic drugs instead.

Lemon Bay Drugs North Inc. of North Port and Brooksville Drugs Inc. of Brooksville were alleged to have pocketed the difference between the name brand and generic medicines. Both pharmacies are managed by Benzer Pharmacy Holding LLC and owned by Alpesh Patel, the U.S. District Attorney's office announced.

The government alleged that the two businesses “knowingly submitted false claims” for reimbursement, and violated the False Claims Act.

The government began its case after a former pharmacy technician at Lemon Bay filed a lawsuit under a “whistleblower” provision of the False Claims Act against the businesses.

The whistleblower in the case will receive $142,500 from the recovery, the government says.

“Those who violate the False Claims Act to generate profit will be held accountable,” says U.S. Attorney A. Lee Bentley III.

The investigation into the businesses was conducted by Assistant U.S. Attorney Kyle S. Cohen, with help from the Department of Health & Human Services' Office of Inspector General, the FBI, the Defense Criminal Investigative Service, the Florida Medicaid Fraud Control Unit, the North Port Police Department and the Sarasota County Sheriff's Office.

The government has been cracking down on health care-related fraud — especially involving Medicaid and Medicare — for the past seven years. Since January 2009, the Department of Justice has recovered more than $31.6 billion through False Claims Act cases. More than half of that figure stemmed from fraudulent activity against federal health care programs, the government notes.