While Pharmacists are usually subject to the same fraud, waste, and abuse rules as other medical providers and those that do business with the government, pharmacists have enjoyed less publicity when it comes to enforcement actions – though they have been targets of such actions.

In April 2023, the U.S. Department of Justice (DOJ) announced that a North Carolina Pharmacy agreed to pay more than $213K to resolve allegations it violated the False Claims Act.  The government alleged that the pharmacy never distributed the prescriptions to beneficiaries, despite submitting claims to government payors for about 200 prescriptions.  While the underlying illegal activities may seem modest, some enforcement actions involving pharmacists uncover large brazen illegal activities and involve criminal culpability.  A recent DOJ announcement is one such example. 

On May 1, 2023, the DOJ announced that the owner of GoLiveWell Pharmacy admitted paying kickbacks to marketing companies to generate prescriptions in violation of the Anti-Kickback Statute (AKS).  The AKS prohibits, among other things, knowingly and willfully paying or receiving payment (i.e., anything of value) in exchange for federal healthcare program referrals.  The government alleged that the owner had deals with marketing companies where GoLiveWell would pay a percentage of its net profit on prescriptions obtained through the marketing companies, who would run ads and “doctor chase.”  Doctor chasing typically involves faxing prescriptions to doctors hoping they inadvertently sign the prescriptions, which ensnares unsuspecting doctors.  The percentages paid by GoLiveWell were also significant, with one marketing company receiving 60 percent and another receiving 45 percent of its net profit.  “In total, the government alleges that Medicare paid GoLiveWell $4.7 million to which it was not entitled, with another $490,000 coming from Missouri Medicaid and $330,000 from Ohio Medicaid.”

For his role in the kickback scheme, the owner of GoLiveWell Pharmacy pled guilty to two counts of the Anti-Kickback statute.  The owner must pay restitution and faces up to 10 years in prison for each count.

The attorneys at Chilivis Grubman represent clients of all types and sizes in connection to False Claims Act litigation, government investigations, and cybersecurity fraud investigations.  If you need assistance with such a matter, please contact us today.