Foot Cream and Kickbacks

close up of word medicare block letter

Fraud cases against government healthcare programs often involve a deep well of people all too willing to scam the program for their personal gain, taking scarce resources from legitimate recipients of Medicare and other programs. That’s been the case with an Oklahoma-based compounding pharmacy, which has been at the center of 11 settlements of wrongdoing in the past year. (That’s a lot of cream. Maybe they should expand their product line.)

In the latest case involving the pharmacy, a Kentucky-based doctor was implicated in an illegal kickback scheme. The 50-year-old podiatrist agreed to pay the government $65,404 for allegedly accepting illegal kickback payments from OK Compounding, LLC, announced U.S. Attorney Trent Shores.

U.S. Attorney Trent Shores, in announcing the settlement, suggested there may be more. “Eleven kickback settlements and counting. The manipulation of our federal health insurance programs cannot be tolerated,” he said. “There are clearly defined laws and standards that must be followed when prescribing compounding medications. Greedy doctors and marketers who have conveniently ignored those laws for their own personal enrichment will be held accountable.”

This civil settlement resulted from an investigation into numerous health care providers writing prescriptions for pain creams compounded and sold by OK Compounding in return for payments.

According to evidence, the Kentucky podiatrist, beginning in 2013, prescribed pain creams for his patients, facilitating the sale and distribution of the creams. As compensation, OK Compounding paid the doctor what was characterized by the parties as “medical director fees” based upon an hourly rate—even though they were kickbacks for selling the pharmacy’s creams. Because some of the patients were insured by Medicare and TRICARE federal health insurance programs, the kickbacks were in violation of the False Claims Act, and multiple federal agencies became involved. (If a doctor or pharmacy couldn’t get enough business before committing fraud, imagine what it’s like after).

To protect the integrity of government healthcare programs—and save funds for those who truly need it—allegations of fraud and abuse in the Northern District of Oklahoma should be reported to the U.S. Attorney’s Office at 918-382-2700.

Today’s Fraud of the Day, “Kentucky Doctor Agrees to Pay $65,404 for Allegedly Engaging in Illegal Kickback Scheme with OK Compounding Pharmacycomes from a U.S. Justice Department press release issued Nov. 8, 2019.

A Kentucky doctor joined a growing list of medical professionals implicated in an illegal kickback scheme involving OK Compounding. This is the eleventh kickback settlement since November 2018.

Jonathan Moore, 50, a licensed doctor of podiatry, agreed to pay the government $65,404 for allegedly accepting illegal kickback payments from OK Compounding, LLC, announced U.S. Attorney Trent Shores.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.