Resolve Alleged False Claims Act Liability

Resolve Alleged False Claims Act Liability

Pharmacy Owner and Pharmacist Employee, a Previously Convicted Felon, Agree to Pay $250,000 to Resolve Alleged False Claims Act Liability

The government alleges that the employee, who was previously convicted of a state controlled substance offense, improperly filled prescriptions and managed pharmacies

PHILADELPHIA (STL.News) Acting United States Attorney Jennifer Arbittier Williams announced that Mark Zulewski, Kaushal Patel, Patel’s company Kass Management & Consulting, LLC, and Patel-owned pharmacies Belmont Pharmacy, LLC; Bensalem Pharmacy; Big Oak Pharmacy, Inc.; Doylestown Drugs, LLC; Family One Pharmacy; Penndel Drugs, Inc.; Penlar Pharmacy; and Medical Plaza Pharmacy have agreed to pay $250,000 to resolve potential liability under the False Claims Act.

Zulewski was a pharmacist licensed in Pennsylvania when, in 2010, he was convicted by the Commonwealth of Pennsylvania of a felony controlled substance offense.  As a result of the conviction, Zulewski’s pharmacy license was suspended and in 2011 he was excluded from participation in federal health care programs by the U.S. Department of Health and Human Services.

The United States contends that Patel hired Zulewski to work in Patel’s pharmacies even though Patel knew that Zulewski had been convicted of a controlled substance offense, and that Patel allowed Zulewski to continue working in his pharmacies even after learning Zulewski was excluded from participating in federal health care programs as a result of his conviction.  The United States further contends that, from August 2010 until March 2017, Patel gave Zulewski broad administrative authority as well as his pharmacist log-in credential so that Zulewski could manage Patel’s pharmacies and, on occasion, fill prescriptions as needed when pharmacists-in-charge at certain of the Kass pharmacies were unavailable.

The United States further contends that Zulewski, Patel, Kass Management, and the Patel-owned pharmacies knowingly and willfully disregarded Zulewski’s exclusion, resulting in the presentation of false or fraudulent claims for payment to the federal programs, including Medicare, Medicaid, and the Federal Employee Health Benefits Program.

The Office of the Inspector General of the U.S. Department of Health and Human Services excludes people from participating in federal health care programs upon their conviction of certain crimes, including a controlled substance offense.  A federal health care exclusion is intended to keep individuals who have violated the law out of Medicare, Medicaid, and Federal Employee Health Benefits programs to protect program beneficiaries and the integrity of federal health care programs.

The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act statute.  Under these provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery.  The suit was filed in the Eastern District of Pennsylvania and is captioned United States of America, ex rel. LaGrossa v. Kass Management & Consulting, LLC, et al., Civil Action No. 15-6844.  The whistleblower’s attorneys are Gavin Lentz and Peter Bryant of Bochetto & Lentz, PC.

“The United States will pursue those who violate a federal health care exclusion and those who knowingly allow excluded individuals to provide goods or services to federal program beneficiaries.” said Acting U.S. Attorney Williams. “An individual convicted of a controlled substances offense, as Zulewski was, must not be allowed behind the pharmacy counter during his exclusion to handle prescription drugs, including narcotics, and dispense them to federal program beneficiaries.”

“Civil enforcement is an important tool in our ongoing battle against health care fraud,” said Maureen R. Dixon, Special Agent in Charge of the Office of the Inspector General for the U.S. Department of Health and Human Services.  “We will continue to work closely with the United States Attorney’s Office to ensure the integrity of taxpayer funds and protect beneficiaries of federal healthcare programs.”

“Exclusions protect Medicare and Medicaid patients and safeguard the integrity of these vital programs,” stated Gregory Demske, Chief Counsel to the Inspector General for the U.S. Department of Health and Human Services.  “Anyone who circumvents an exclusion undermines the goal of ensuring Medicare and Medicaid patients receive safe, appropriate, and high-quality, services.”

The government’s resolution of this matter illustrates the government’s emphasis on combating health care fraud.  One of the most powerful tools in this effort is the False Claims Act.  Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

This matter was investigated by the U.S. Department of Health and Human Services’ Office of Inspector General, the U.S. Office of Personnel Management’s Office of Inspector General, and the U.S. Attorney’s Office for the Eastern District of Pennsylvania.  This matter was handled by Assistant U.S. Attorney Judith A.K. Amorosa and Fraud Investigator Jeffrey Braun.

The claims resolved by this settlement are allegations only and there has been no determination of liability.

SOURCE: USDOJ.Today

About Waqar Nawaz 3855 Articles
Waqar Nawaz has published content for STL.News for approximately three years. He is dedicated to publishing news released by the US Department of Justice. He actively monitors the web for fresh releases to help keep the public informed.