Posts Tagged ‘Compounding Pharmacy’

Rare Case of Patient Whistleblower leads to Successful Settlement

AgeVital agrees to pay $775,000 to settle kickback claims

[*See video below on coverage of the settlement on WFLA channel 8 in Tampa. James Hoyer Attorney Jesse Hoyer is interviewed*]

SARASOTA, FL – The action of one patient who recognized possible fraud against Medicare led to this settlement which returns nearly one million dollars to taxpayers.  Vital Life Institute LLC, known as AgeVital Pharmacy LLC, along with owners Jenny and William Wilkins, have agreed to pay at least $775,000 to resolve claims that they violated the False Claims Act by engaging in an illegal kickback scheme.

“The importance of this settlement goes far beyond the amount recovered. It demonstrates the value and impact of everyday citizens who come forward to expose fraud,” said attorney Jesse Hoyer, local counsel for the whistleblower case. “Medicare, Medicaid and Tricare beneficiaries who carefully review their Explanation of Benefits statements can make a difference.”

The settlement resolves allegations that Sarasota-based AgeVital paid kickbacks to a third-party marketing company to solicit patients for compounded drug prescriptions, regardless of patient need. The marketing company allegedly arranged for prescribers to sign those prescriptions, which were then referred to AgeVital to be filled in exchange for a substantial share of Tricare and Medicare reimbursements.

Details of case

The case was filed in federal court in Tampa in 2015, after Manfred Knopf, a patient in New Jersey who received prescriptions he did not need or want, recognized that Medicare was billed for the products. AgeVital solicited Mr. Knopf to purchase the expensive compounded pharmaceuticals after he suffered a slip and fall accident that required treatment for his injuries.

Despite never agreeing to receive these medications, AgeVital began sending containers of expensive compounding creams to his doorstep. The healthcare prescriber listed on the packages delivered was Dr. Jean Wilson, a provider Knopf had never heard of or been treated by. Medicare paid approximately $37,377 for these medically unnecessary compounded pharmaceuticals sent to Knopf. After recognizing what he believed was fraud, Knopf decided to report his concerns to the government.

With the assistance of attorney David Williams of Kline & Specter, P.C. (along with Jesse Hoyer and Elaine Stromgren of James Hoyer, P.A.), the lawsuit was filed under the qui tam or whistleblower provisions of the False Claims Act. The Act allows private citizens who suspect

fraud against the government to bring a lawsuit on behalf of the United States for false claims and to share in any recovery. 

“The False Claims Act gives us a powerful tool with which to expose fraud and recover money on behalf of taxpayers. We thank Mr. Knopf for recognizing the fraud and having the courage to bring it to the Government’s attention,” said attorney Hoyer.

Anti-Kickback Statute

The Anti-Kickback Statute prohibits the knowing and willful payment of compensation to induce the referral of services or items that are paid for by a federal health care program. Individuals and entities can be subject to liability under the False Claims Act for submitting claims to federal health care programs in violation of the Anti-Kickback Statute.

“Kickback schemes undermine public trust in our health care system and lead to unnecessary health care costs at taxpayers’ expense,” said Assistant Attorney General Jody Hunt for the Department of Justice’s Civil Division.

“We will not tolerate those who profit at the expense of taxpayers by entering into illegal kickback arrangements,” says U.S. Attorney for the Middle District of Florida Maria Chapa Lopez. “Our office is committed to holding individuals accountable for corporate malfeasance.”

Mr. Williams, Ms. Hoyer and Ms. Stromgren sincerely appreciate the efforts of the Civil Division’s Commercial Litigation Branch, the U.S. Attorney’s Office for the Middle District of Florida, the FBI, the Defense Criminal Investigative Service and the U.S. Department of Health and Human Services Office of Inspector General that contributed to the resolution of this case.

Kline & Specter P.C. is a nationwide personal injury and medical malpractice law firm with offices in Pennsylvania, New Jersey, Delaware, and New York.

James Hoyer, P.A. is a nationwide whistleblower and employment law firm with offices in Florida, Washington D.C., and Michigan.