Opioid abuse is an epidemic. In 2016, there were 63,632 drug overdose deaths in the United States. Of those deaths, 66.4 were caused by opioids. While prescription opioids and other narcotics may play an essential role in the treatment of chronic pain, unscrupulous physicians who place profit above patient safety have undoubtedly contributed to rising rates of addiction and abuse.
The Justice Department recently announced that a fraud enforcement operation across the state of Texas resulted in charges against 58 individuals in connection with “pill mill” clinics. Among those charged include doctors, pharmacists, pharmaceutical marketers, and Durable Medical Equipment (DME) sales companies. Collectively, the Defendants reportedly defrauded Medicare, Medicaid, TRICARE and the Department of Labor out of $66 million dollars and dispensed more than 6.2 million pills.
“Pill Mill” pharmaceutical fraud can form the basis of a violation of the Federal False Claims Act in various ways, including:
- Prescription of opioids, narcotics, and compound creams that are not reasonable or medically necessary.
- Prescription of certain classes of controlled substances by a provider not authorized under state law to issue such prescriptions.
- Overuse and abuse of routine urine drug screens.
- Upcoding/overbilling government healthcare payors for the time spent with the patient in consultation.
- Payment of kickbacks to providers for referrals for pain management procedures and urine drug screens.
Whether you are a patient or employee, if you believe you have discovered evidence of pharmaceutical fraud, contact our office for a free consultation regarding your whistleblower claims.
Read this DOJ Press Release for more info:
 Seth, P, et al, 2018, “Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants – United States, 2015-2016”, CDC Morbidity and Mortality Weekly Report, vol. 67, no. 12, pp. 349-358.
2] Department of Justice. (September 18, 2019). Texas Healthcare Fraud and Opioid Takedown Results in Charges Against 58 Individuals [Press release]. Retrieved from https://www.justice.gov/opa/pr/texas-health-care-fraud-and-opioid-takedown-results-charges-against-58-individuals