The need for medical fraud defense has been on the rise. One such area of medical fraud involves compounding pharmacies. In recent years, the medical field has grown increasingly attached to medication specific prescriptions that suit individuals best on a case by case basis. Because large drug manufacturing companies cannot profit adequately by producing individually created medications, smaller, more unique compound pharmacy groups, have subsequently filled the gap between patient and doctor prescriptions. Compounding itself is a process by which pharmacists mix individual ingredients together to create a personalized dosage and strength of a drug that will have an increased effect on a patient. While such a combination can serve as an immediate benefit to a patient seeking a prescription, the pharmacy groups that produce such compounds have an extensive liberty when it comes to creating these drugs, which can sometimes, and as of late, increasingly often, lead to abuse in the medical field.
Compound Pharmacy Medical Fraud
Medical fraud problems arise when negotiations between doctors and compound pharmacies turn into kickback schemes and over billing that financially injure a patient or insurance company. Some specific instances that indicate medical fraud activity by either a physician, compound pharmacy, or both, include, but are not limited to:
- The prescription of compounds to patients that are medically unnecessary
- False advertising of compounded drugs that are claimed to be FDA-approved
- Compounding pharmacies proposing kickbacks or bribes to doctors in return for prescriptions and referrals
- Over billing to a patient or insurance company for compound drug prescriptions
In an attempt to combat the potential for malpractice, Congress has passed multiple statues to prevent such abuse, which include the Anti-Kickback Statute, the Health Care Fraud Statute, and the False Claims Act. However, despite the passage of these measures, compound pharmacies and physicians continuously violate laws that place themselves under scrutiny by the government.
Potential Charges and Punishments
Often, a physician may not even be aware that he or she has engaged in medical fraud and initially believed that they were prescribing a medication to a patient that had a significant medical benefit, yet are criminally charged regardless. Physicians and compounding pharmacies, after being investigated by federal or state agencies, initially face restitution charges that must be paid back if there are damages to be paid. In addition, they could face numerous counts of intent to medically defraud another individual and the potential violation of the acts stated above, which each constitute additional fines and maximum prison sentences of 5 to 10 year periods, depending on if the case is charged in federal, or varying state courts. More importantly, if a physician is convicted of any misdemeanor or felony, their medical license could be suspended indefinitely as a result of being convicted of a crime.
Compounding Pharmacy and Medical Fraud Defense
Being charged with medical fraud and large restitution fines should be handled by experienced attorneys to prevent a conviction from landing on your record. The criminal defense team at Kenney Legal Defense has specialized in fraud cases with our work for over 20 years. Chairing over 70 jury trials, our legal team works relentlessly to avoid convictions and get the best outcomes for our clients. If you or a loved one is under federal investigation or has recently been charged with a medical fraud crime, contact us at (855) 505-5588 right away!