A pair of Jacksonville pharmacies and their owner agreed to pay at least $7.4 million to settle lawsuits accusing them of defrauding Medicare by adding anti-psychosis medication to topical pain cream and wrongly waiving patient copays.
Smart Pharmacy Inc., SP2 LLC. and owner Gregory Balotin were accused by federal authorities of adding the anti-psychosis medicine aripiprazole, sold as Abilify, to topical pain creams to get more money in reimbursement from the government.
Aripiprazole can be used to treat schizophrenia and Tourette’s disorder.
Medicare Part D and TRICARE, which serves U.S. military personnel and their dependents, repay pharmacies for individual ingredients in compounded medicines. As such, the purported addition of aripiprazole to the creams would have allowed the pharmacies to get more money back from the federal government.
The pharmacies were also alleged to have routinely waived patient copays regardless of whether or not the patient qualified for such a waiver to induce people to buy the altered pain cream.
“When pharmacies inflate their revenue with medically unsupported prescription ingredients, they compromise the quality of patient care and waste taxpayer dollars,” Principal Deputy Assistant Attorney General Brian Boynton said.
The suits were filed in June 2019 by two former Smart Pharmacy employees, Amy Sanchez and Ashok Kohli, under the whistleblower provisions of the False Claims Act.
As such, they will receive an undetermined share of the settlement totaling at least $7.4 million.
The total amount paid out will depend on Mr. Balotin and the pharmacies’ ability to pay. The settlement also stipulates that Mr. Balotin and the pharmacies will be subject to an independent annual claims review for the next three years.
Under the terms of the settlement, neither the businesses nor their proprietor was held legally liable and the claims of wrongdoing asserted against them were deemed merely allegations.
• Brad Matthews can be reached at bmatthews@washingtontimes.com.
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