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Delivery Time for Fraud

Healthcare-Medicare-2
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

The number one complaint about mail order pharmacies is the delivery time. Most mail order pharmacies promise delivery within 7-10 business days. That can be an issue with a new medication or the urgent need for medication when a patient runs out. But what can be an inconvenience for the consumer, can be an advantage for a fraudster. Especially when the patient doesn’t know they are getting a prescription delivered for anti-fungal foot cream.

GoLiveWell primarily functioned as a mail-order pharmacy, which filled prescriptions for federal health insurance beneficiaries only. But for the owner, Michael McCormac, he was just trying to “Go Live Well” off of the U.S. taxpayer. In exchange for kickbacks, McCormac received prescriptions from marketing companies who ran ads in the hopes that patients would mistakenly “opt in” to receiving prescriptions for expensive drugs. The companies also engaged in the so-called “doctor chase,” where they fax prescriptions to doctors’ offices in hopes that the doctors just sign them.

Those prescriptions included topical creams, oral medications and antibiotic and antifungal “foot bath” drugs. Claims for payment for the drugs were then submitted to federal health plans including Medicare and the Missouri Medicaid and Ohio Medicaid programs. It was a lucrative mail order scheme for McCormac. In total, the government alleges that Medicare paid GoLiveWell $4.7 million to which it was not entitled, with another $490,000 coming from Missouri Medicaid and $330,000 from Ohio Medicaid. Prescription delivery wasn’t slow enough for McCormac. On May 2, 2023, McCormac pleaded guilty to medical fraud of a Medicaid program.

Outstanding job by the Medicaid Fraud Control Units of Missouri and Ohio with this investigation.

Today’s Fraud Of The Day is based on article “Former Missouri pharmacy owner pleads guilty to paying kickbacks for prescriptions” published by Missouri State News  on May 2, 2023

The former owner of a Creve Coeur pharmacy on Monday admitted paying illegal kickbacks to marketing companies to generate prescriptions for expensive medications.

Michael J. McCormac, 55, pleaded guilty in front of U.S. District Judge Rodney W. Sippel to two counts of violations of the Anti-Kickback Statute.

At the time of the crimes, McCormac owned GoLiveWell Pharmacy, which operated primarily as a mail-order pharmacy supplying customers across the country. McCormac admitted striking deals with marketing companies in which GoLiveWell would illegally kick back a percentage of the pharmacy’s net profit on prescriptions obtained through the marketing companies’ efforts.

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