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Can a pharmaceutical manager go to prison for healthcare fraud?

On Behalf of | Oct 12, 2023 | Health Care Investigations |

Pharmacies help people in their communities. Those who work in these healthcare facilities try to help provide patients and community members with the medications they need to treat illness or injury. In a recent case, the government claims a pharmaceutical manager and employees used their facility not to help their community but instead to bilk the government of millions of dollars.

What happened in this case?

The prosecution focused on two arguments. First, the use of bribes. The prosecution claims the pharmacy paid bribes to physicians in exchange for the physician recommending patients use their pharmaceutical services. Bribes allegedly included expensive meals as well as cash payment and money transfers.

Next, fraudulent billing. The government also claims that, in addition to these bribes, the manager billed Medicare and other government providers for prescriptions that the patients never received. The prosecution claims that when a third-party conducted an audit the manager forged shipping records to make it appear the pharmacy sent the prescriptions to patients. They argue these records were false and pushed for additional criminal charges.

When faced with the evidence, the pharmacy manager plead guilty to conspiring to commit healthcare fraud and conspiring to violate the federal anti-kickback statute. The first comes with up to ten years imprisonment, the second with five. Both also come with an additional $250,000. Two other employees with the pharmacy already accepted plea deals, one awaiting sentencing and the other with a court sentence of 41 months in prison for his role in the scheme. Two additional individuals still face criminal charges.

Circling back: Can a pharmacy manager go to prison for healthcare fraud?

If the government can build a successful case, then the manager could face prison time. This is why it is so important to take these allegations seriously. It may seem like since no one was injured the government and court system would be lenient — but they are not. They will pursue charges and, if possible, push for imprisonment. It is important to seek legal counsel experienced in this niche area of healthcare law to discuss your options and better ensure your rights are protected.

Attorney John Rivas is responsible for this communication.

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