LYONS, Ga. (WSAV) — On Thursday, Attorney General Jeff Sessions and Department of Health and Human Services (“HHS”) Secretary Tom Price, M.D., announced the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics.
As part of this national enforcement action, the United States Attorney’s Office for the Southern District of Georgia announced their enforcement action, and WSAV’s report on this matter included several healthcare providers from our area, including the following:
- The United States filed a Criminal Information against Sherry McCormick alleging one count of Health Care Fraud. In the information, the United States alleged that from 2013 to 2015, McCormick defrauded Medicare, Tricare, and the Federal Employee Health Benefit Program of approximately $500,000 by submitting and causing the submission of fraudulent claims for medications that were not medically necessary and not prescribed by a doctor.
- The United States reached a civil settlement with Allcare Pharmacy, a pharmacy operating out of Lyons, Georgia, totaling $175,000. Based on the actions of its former employee, McCormick, the United States contended that Allcare Pharmacy submitted claims and received payment for prescriptions for compounded medications that were not medically necessary and not prescribed by a doctor.
On Monday, July 17, representatives for Allcare Pharmacy released the following statement to address those claims:
“Last week, the United States Attorney’s Office for the Southern District of Georgia announced that Allcare agreed to pay $175,000 to resolve a False Claims Act matter. Since receiving a request for information from the government in February of this year, Allcare has cooperated fully with the government, and continues to do so.
Recently, Allcare learned that the investigation revolves around one of Allcare’s former employees – Sherry McCormick – purportedly entering into an unlawful kickback arrangement with a prescribing physician. Although Allcare did not know about this purported arrangement, nor did it have any reason to know, as soon as Allcare became suspicious of certain prescriptions sent from the physician in question, Allcare immediately terminated Ms. McCormick’s employment and ceased filling any new prescriptions from that physician.
As outlined in the government’s press release, the government recently filed criminal charges against Sherry McCormick. Allcare plans to assist the government in any way that it can in connection with that matter. In light of the fact that Allcare’s former employee was engaged in criminal conduct that – unbeknownst to Allcare – may have resulted in unnecessary prescriptions being filled, Allcare has agreed to repay the government $175,000. While the details of the settlement are still being finalized, the settlement will not include any admission of liability on the part of Allcare, and Allcare’s ability to continue to participate in federal healthcare programs will not be affected in any way.
Although Allcare had no knowledge of the purported kickback arrangement at issue, Allcare agreed to an amicable resolution with the government so that it could get back to business as usual, and because the cost of litigating this matter would far outweigh the settlement amount. Allcare is pleased that it is able to resolve this matter amicably and continue to serve its customers, as it has since its inception. This matter should serve as a stern warning to everyone affiliated with Allcare that Allcare takes its compliance
obligations very seriously, and will simply not tolerate anyone affiliated with the pharmacy acting in any way other than in full compliance with all laws, rules, and regulations.”