(CW44 News At 10) - Thanks to a whistleblower at a pharmacy, two Florida men that formerly owned a telemarketing company will be at least $4 million lighter in the pocket.
On Tuesday, Two Florida men have agreed collectively to pay at least $4 million to resolve allegations that they violated the False Claims Act by engaging in schemes to generate prescriptions for compounded drugs and refer those prescriptions to pharmacies in exchange for illegal kickbacks. Many of those prescriptions were billed to TRICARE, the federal health care program providing insurance for active duty military personnel, military retirees, and military dependents.
Jack Lee Stapleton, of Gulf Stream, Florida, and Jack Hunter Stapleton, of Fort Lauderdale, Florida, formerly owned a marketing business in Fort Lauderdale, Florida, which operated under various names, including CV McDowell LLC, and J&J Tel Marketing LLC (the Stapleton Entities). The United States alleged that the Stapleton Entities, under the Stapletons' direction, used telemarketing to solicit prospective patients to accept compounded drugs regardless of patient need, procured prescriptions for those patients, and then sent those prescriptions to compounding pharmacies that agreed to pay the Stapleton Entities half of the amount TRICARE reimbursed for each prescription. The Stapletons and Stapleton Entities worked with pharmacies to identify compounded drug formulas that maximized the level of reimbursement for the drugs, regardless of the medical need for the chosen formula. They then sought to procure large volumes of prescriptions for those formulas. In many cases, the Stapleton Entities procured prescriptions by paying telemedicine providers who prescribed expensive compounded drugs without ever seeing the patients or conducting any meaningful medical examination.
"Kickback arrangements undermine confidence in our health care system," said Acting Assistant Attorney General Brian M. Boynton of the Department of Justice's Civil Division. "This case demonstrates how kickback schemes often result in the provision of medically unnecessary services at the taxpayer's expense. The department is committed to holding accountable those who engage in such unlawful conduct."
As part of the settlement, the Stapletons have agreed to pay additional amounts in the event of certain contingencies.
The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Dwayne Thornton against the Stapletons. Under the qui tam provisions of the False Claims Act, a private party can file an action on behalf of the United States and receive a portion of the settlement if the government takes over the case and reaches a monetary agreement with the defendant. Mr. Thornton is a former employee of one of the pharmacies to which the Stapleton Entities referred prescriptions. The share to be awarded from this settlement has not yet been determined.
The claims resolved by the settlement are allegations only and there has been no determination of liability.
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