In an action filed by certain patients of the pharmacy as Relators under the federal False Claims Act (the “FCA”), the Relators contended, on behalf of the United States, that the pharmacy violated the FCA by submitting claims to United States Department of Labor (“DOL”) for a non-controlled compound supplement, that were either not ordered by a licensed provider or not delivered to the beneficiary.
Mandelbaum Barrett’s Healthcare and White Collar/Governmental Investigations Practice Groups, in conjunction with Florida co-counsel, Sisco Law, defended the action by presenting exculpating evidence to government to support the propriety of the pharmacy’s billing practices. As a result, the pharmacy reached an amicable settlement with the government on favorable terms. Specifically, the pharmacy agreed to pay approximately 10% of the alleged loss amount to the government and a reduced attorney fee amount to the relators’ legal counsel. In return, the government waived civil and administrative monetary claims under the FCA, the Program Fraud Civil Remedies Act and the common law theories of payment by mistake, unjust enrichment, and fraud. Additionally, the DOL – Office of Workers’ Compensation waived its right to exclude the pharmacy under the applicable DOL program. Finally, in an effort to ensure the finality of the settlement, the Mandelbaum Barrett-Sisco Law team also secured a representation from the government, in the form of “cold comfort” letters, that it had closed the corresponding criminal investigation involving defendants and had no intention to proceed civilly against the defendants related to the other allegations in the complaint.
Mandelbaum Barrett’s team, consisting of healthcare fraud lawyers, including former state and federal prosecutors, commercial litigators and a consulting pharmacist, effectively represents clients in FCA cases by combining its deep substantive knowledge of healthcare laws and regulations with its vast experience in defending and resolving FCA cases.
Please contact Mohamed H. Nabulsi, Esq. if you have any questions or comments regarding FCA cases.
These stories are successful case results from our attorneys. Please note that results may vary depending on your particular facts and legal circumstances.