Whistleblower litigation under the False Claims Act often involves fraudulent Medicare and Medicaid claims for prescriptions drugs. Sometimes the false claims are made by the drug manufacturer that, for example, markets a drug for an off-label use. Other times, the false claims are made at the far end of the supply chain, by a pharmacy that finds a way to bilk the taxpayers out of millions of dollars.
That’s what happened in Miami, Florida with three discount pharmacies co-owned and operated by Jose Carlos Morales, 55. Morales pleaded guilty to one count of conspiracy to pay illegal health care kickbacks and one count of conspiracy to commit health care fraud in connection with a prescription drug fraud scheme involving $23 million.
Morales co-owned PharmovisaMD Inc. and Pharmovisa Inc., discount pharmacies in Miami that the government alleges paid illegal kickbacks to Assisted Living facilities (ALFs) in exchange for the referral of a steady stream of Medicaid and Medicare beneficiaries to the pharmacies. The ALFs allegedly were paid $30 per patient per month for each referral. Morales also was alleged to have paid illegal kickbacks to doctors in return for their referral of prescriptions that ultimately were paid for by Medicare.
False Claims for “Bingo Card” Prescription Drugs
The Justice Department alleged that Morales had another fraudulent scheme involving prescription drugs contained on pop-out cards from which pills are punched out one at a time through a foil lining on the back. Morales allegedly referred to these as “bingo cards.” Pharmacy drivers would deliver the bingo cards to ALFs throughout the Miami/South Florida region. The government claimed that Morales ordered drivers to pick up prescription-bingo cards with any unused pills still on them, which pills were then placed into bottles back at the pharmacy and rebilled to Medicare or Medicaid the next time a prescription was filled.
Waters & Kraus Assisting Whistleblowers in False Claims Act Lawsuits
Whistleblowers help the government call an end to health care schemes involving prescription drug fraud. It’s crucial that you know your legal rights under the False Claims Act. Waters & Kraus’ qui tam lawyers can help. Send us an email or call our whistleblower attorneys at 800.226.9880 to learn more about our firm and what we can do to help.