The Importance of a Pharmacy Compliance Program | Oberheiden

The Importance of a Pharmacy Compliance Program | Oberheiden P.C.


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As federal agencies and law enforcement investigate pharmacies around the country for health care fraud and kickback schemes, pharmacies should be proactive in understanding their regulatory environment and the importance of setting up strong pharmacy compliance programs.
Federal agencies such as the Department of Justice (DOJ) and the Securities and Exchange Commission (SEC) are increasing their investigative efforts to scrutinize pharmaceutical companies and their executives for health care fraud.
In July 2020, a pharmaceutical company and its former executives were charged with improper revenue recognition and misleading disclosures in SEC filings and earnings presentations and agreed to pay a $45 million penalty to settle these charges. Additionally, in January 2021, a co-owner of compounding pharmacies and pharmaceutical distributors was sentenced for conspiracy to commit health care fraud in a multi-million dollar scheme that defrauded TRICARE and other health care benefit programs. More recently, the DOJ in mid-March 2021 charged a pharmacist with a $4 million health care fraud and kickback scheme for his role in a conspiracy involving billing Medicare and Medicaid for prescription drugs that were not eligible for reimbursement.

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