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Defending Against Compound Pharmacy Fraud

Pharmacies are crucial to the safety, health, and ease of the general public. As essential as these establishments are, they occasionally face scrutiny for the methods by which they conduct business. Individuals working in the compound pharmaceutical industry can be prepared to defend themselves against charges of compound pharmacy fraud by enlisting the assistance of an experienced criminal and civil defense attorney. 

What is a Compound Pharmacy?

A compound pharmacy and a regular pharmacy differ in some fundamental ways. To begin with, a compound pharmacy specializes in the creation of medications that meet the healthcare needs of every individual patient. Each drug that a compound pharmacy creates is tailored to a single customer and their distinctive medical situation.

Furthermore, compound pharmacies constitute a comparatively small percent of pharmacies in the U.S. Of the 56,000 or more established pharmacies, only 7,500 of them are compound pharmacies or are capable of making compound pharmaceuticals. The drugs are created by licensed physicians as well as pharmacists and other trained professionals who work under the supervision of an experienced compound pharmacist.

Lastly, the compound pharmaceuticals concocted by these facilities are not endorsed by the FDA, and the FDA cannot guarantee their quality, effectiveness, or safety.

Nevertheless, compound pharmacies are imperative for various reasons. Some of the reasons these pharmaceuticals may be created include:

  • OTC or Over-the-Counter medications not satisfying the healthcare needs of the patient
  • The patient has allergies to OTC or prescribed medications
  • A scarcity of medications
  • A particular drug is no longer produced

The medicines that compound pharmacies create span from creams to capsules to liquids.

What is Compound Pharmacy Fraud?

Compound pharmacy fraud is a form of healthcare fraud that is committed against health insurers like Tricare, Medicaid, Medicare, and private health insurance companies. It incorporates giving kickbacks to chiropractors, doctors, and pharmacists for referrals. It covers billing for unnecessary products or ingredients, overbilling, mass compounding, providing ongoing refills for medications, and making medications that are the same as those sold commercially or over-the-counter as well.

The federal government considers compound pharmacy fraud as a severe offense and relegates investigations into it to agencies like the:

  • FBI (Federal Bureau of Investigation)
  • DEA (Drug Enforcement Agency)
  • FDA (Food and Drug Administration)
  • HHS (Department of Health and Human Services)
  • Office of Inspector General

Investigating Compounding Pharmacy Fraud

These agencies are commissioned with focusing workforce and resources into investigating compound pharmacy fraud.

Depending on the sort of fraud being inspected, the investigation can initiate with the compound pharmacy being served with a subpoena. The subpoena will typically ask the business to provide such documentation as:

  • Physician relationships
  • Financial records
  • Marketing agreements
  • Other business records

The warrant may not necessarily elucidate if the investigation is civil or criminal. For this reason, owners and pharmacists of compound pharmacies are encouraged to retain legal counsel to analyze the subpoena and advise them on how to proceed accordingly.

The investigation may also include agents from the FBI, DEA, and FDA arriving at the pharmacy and requesting to speak with its staff and employees. The agents may present a search warrant that allows them access to the premises as well. The pharmacy should have an attorney present to peruse the warrant and be available if or when any of the owners or employees are questioned.

As a matter of fact, during compound pharmacy fraud investigations, agents are permitted to speak with anyone affiliated with the business, such as the:

  • Owner or owners
  • CEO or COO
  • Pharmacists
  • Marketers
  • CFO or other financial experts
  • Physician owner
  • Physician referrals

Any person who owns, works for, or is otherwise affiliated with the compound pharmacy could face criminal and civil charges for fraud depending on the findings in the investigation. Many recent cases reveal the gravity of these investigations. For instance, the owner of a New Jersey compound pharmacy pleaded guilty to bribing and giving kickbacks to doctors who referred patients to his business for pain relief cream prescriptions. He was pronounced guilty of defrauding insurers out of hundreds of thousands of dollars by misleading them about the ingredients of the products.

Furthermore, California investigators charged 15 defendants with deceiving the compensation program for the state’s workers. They defrauded the program out of $100 million and paid healthcare providers kickbacks amounting to $25 million for patient referrals.

The penalties for compound pharmacy fraud will vary depending on the state in which the fraud was perpetrated. The penalties depend on whether or not the charges are pursued at the federal or state level as well.

Penalties for Compounding Pharmacy Fraud

The penalties of a guilty conviction in a compounding pharmacy fraud case can span from civil fines to sentencing in a federal or state prison. It is not uncustomary for judges to mete out penalties such as reimbursing defrauded victims, victim’s court costs, and attorney fees. In the events that the fraud resulted in injuries or death of patients, compounding pharmaceutical employees, owners, or vendors could be convicted to prison sentences spanning from 10 years to life.

Defending Against Compounding Pharmacy Fraud Charges

Professionals in the compounding pharmacy industry in Georgia who are facing fraud charges should hire Hasson Law Group LLP to take their cases without further delay. Our team of attorneys has the expert knowledge and extensive experience of both the legal and pharmaceutical industries to effectively defend our clients in fraud cases that could cost them their freedom and money.

Hasson Law Group LLP knows the state’s compounding pharmacy fraud laws and the application of them to the cases we handle. We can assist pharmacy owners in arranging their businesses to avoid fraud charges, to begin with. We protect our clients’ rights, present evidence to defend their innocence, and work diligently toward the desired outcome of every case we represent.

Building a successful defense against compound pharmacy fraud charges starts by contacting our team of expert attorneys at Hasson Law Group LLP. It may seem like a daunting and even intimidating take, but hesitating to hire an Atlanta compounding pharmacy fraud attorney at the onset of an issue could be damaging to your case and your license. You could lose your license, face fines, and even suffer jail time if you don’t have the right representation.

Compound pharmacies offer imperative services to the public, and these businesses often find themselves under extreme inspection from federal inspectors. When fraud charges are brought up against compound pharmacy owners, employees, pharmacists, vendors, and other affiliated professionals, they require the assistance of competent attorneys to handle their cases. They can safeguard themselves against these charges by entrusting their cases to Hasson Law Group LLP today.

Hire an Atlanta Compound Pharmacy Fraud Attorney Today

We bring our prestigious large law firm and government service backgrounds to a small firm setting to offer you our extensive expertise in a personal, individualized approach where each case gets our full attention and our clients know they’re our priority. It’s with this personalized and customized attention that we can help protect your business against any risk by being proactive. By waiting to call an attorney, you could be jeopardizing your business and yourself by leaving yourselves vulnerable. Consult with an Atlanta compound Pharmacy Fraud attorney to get ahead of the circumstances and avoid complications. We welcome you to call Hasson Law Group LLP at (678) 701-2869 to speak with an expert attorney who has the experience required to keep you in good standing and safeguard your license and your future. We are proud to serve the Atlanta, Georgia area since 2013.

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    Hasson Law Group LLC

    The Hasson Law Group, LLP, is an Atlanta, GA law firm dedicated to two principal practice areas: winning high stakes disputes in the areas of business litigation, insurance recovery, and complex criminal defense, and tax, corporate and regulatory law mechanisms affecting family businesses, tax-exempt organizations and the individuals who support or serve them.

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