US seizes Miss. properties in pharmaceutical scheme
Source: Clarion Ledger
The U.S. government claimed civil forfeiture of multiple properties in the Pine Belt and other areas worth at least $11 million following an Internal Revenue Service investigation that uncovered alleged money laundering, health care fraud and other criminal acts.
"Based on the information obtained so far, the subjects of this investigation own and operate numerous pharmacies that market and prepare compounded medications," IRS Special Agent Darren Mayer said in a declaration in support for a complaint of forfeiture in rem, adding, "Many of the subjects have engaged in price rolling," in which a pharmacy submits a claim to an insurance provider to "test" the amount the provider will reimburse for a specific prescription, then canceling the claim. The employee then submits a claim for a compounded formulation to see if that is reimbursed at a higher rate.
According to Cornell University Law School, civil forfeiture rests on the idea that the property itself, not the owner, has violated the law. Unlike criminal forfeiture, in rem forfeiture does not require a conviction or even an official criminal charge against the owner.
Other techniques Mayer described include split billing (splitting a prescription into smaller supplies, then charging a dispensing fee) and automatic refills despite doctors' orders or patients' wishes. Some patients reported having received prescription medicines without having seen the doctor who prescribed
Read more: http://www.clarionledger.com/story/news/local/2016/06/06/us-seizes-miss-properties-pharmaceutical-scheme/85537968/
