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DOJ Files Whistleblower Complaint Against PharMerica

The Department of Justice (DOJ) announced that the U.S. Government filed a lawsuit against PharMerica Corp., a long-term care pharmacy in the U.S. District Court for the Eastern District of Wisconsin.  The lawsuit accuses PharMerica of billing Medicare for Schedule II controlled substances dispensed without a valid prescription in violation of the Controlled Substances Act and the False Claims Act. 

PharMerica fills approximately 40 million prescriptions annually, serving approximately 300,000 residents of nursing homes, skilled nursing facilities and other long-term care facilities.  PharMerica dispenses controlled substance drugs including oxycodone and fentanyl, which cause significant harm if misused. 

“Pharmacies are prohibited by law from dispensing Schedule II narcotics, which have the highest potential for abuse of any prescription drug, without a valid prescription from a physician,” said Stuart Delery, Assistant Attorney General for the Civil Division of the Department of Justice.  “As we have done today, the Department of Justice will take action to protect the integrity of Federal health care program funds and hold those who violate the law accountable.” 

Jennifer Denk, a former PharMerica employee, filed a complaint on behalf of the U.S. Government as a “relator” under the qui tam provisions of the False Claims Act, against PharMerica in July 2009.  The government may intervene and recover three times its damages plus civil penalties pursuant to the False Claims Act.  Ms. Denk’s complaint was subsequently consolidated with a complaint filed by Eric Beeders and Lesa Martino in May 2010. 

“The complaint that we are filing today reflects the abiding commitment of the Justice Department to the qui tam process, encouraging people with information about alleged fraud and abuse to report it in a timely and effective manner,” said James L. Santelle, U.S. Attorney for the Eastern District of Wisconsin.  “The False Claims Act allegations in this case, which involve Medicare billings for the dispensing of Schedule II controlled substances absent valid prescriptions, are precisely the type of allegations that our office and the Civil Division examine carefully, investigate fully, and prosecute vigorously—to protect taxpayer monies and to promote the delivery of professional health care to all of our constituents.”

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