Philadelphia Pharmacy Employees Charged for Drug Diversion and Fraudulent Billing Practices

A years-long investigation of the top retail pharmacy purchasing oxycodone in Pennsylvania has come to resolution.

The pharmacy engaged in reckless controlled substance dispensing, ignoring signs of diversion (i.e., accepting blatantly forged prescriptions and sizable amounts of cash payments for drugs) and dispensing opioids in extreme doses or in combination with other “cocktail” drugs.  In addition, the pharmacy took part in an extensive health care fraud scheme. The pharmacy would fraudulently bill for drugs that were not intended to be dispensed. A hallmark part of the scheme involves employees using the code “BBDF” or “Bill But Don’t Fill” in their computer system to communicate the prescriptions that were merely to be billed without dispensing medication to the patient as a means to further their profits.

The owner pled guilty and was sentenced to 42 months in prison for his role. He also plead guilty to having conspired with others to ultimately engage in this health care fraud scheme and illegally dispensing oxycodone. The owner and his business agreed to pay $4.1 million to resolve the company’s civil liability. In addition, the company will not be permitted to dispense any controlled substances in the future and will be unable to bill federally-funded programs for 22 years.

Two former employees of the pharmacy also plead guilty to charges alleging they knowingly dispensed oxycodone without a valid prescription, resulting in 3 months and 4 months in prison, respectively. In addition, they each agreed to pay the United States in order to resolve civil allegations and committed to never dispense any controlled substances going forward.

Although the pharmacy’s motives were blatant violations of the Controlled Substance Act and False Claims Act, that is not always the case. Ensure your pharmacy staff has a good grasp on proper billing habits and a policy manual for preventing, detecting and report Fraud, Waste and Abuse. See PAAS National^®’s compliance program for more information or call us at 608-873-1342.