A federal jury in Houston convicted a Texas pharmacist on September 13, 2023, for her role in a pill-mill pharmacy that unlawfully dispensed over 100,000 opioid pills in exchange for cash.
According to court documents and evidence presented at trial, from January 2014 to January 2018, the defendant was a relief pharmacist at a cash-only, pill-mill pharmacy. The pharmacy dispensed controlled substances to drug traffickers in exchange for hundreds of dollars, often based on prescriptions that were fraudulent and issued in the names of physicians whose identities were stolen. The defendant filled large volumes of cookie-cutter prescriptions for the opioids hydrocodone 10-325mg and oxycodone 30mg and for carisoprodol, alprazolam, and promethazine with codeine, often in combination, knowing these controlled substances were likely to be diverted or abused.
The jury convicted the defendant of one count of conspiracy to unlawfully distribute and dispense controlled substances. She is scheduled to be sentenced on Jan. 11, 2024, and faces a maximum penalty of 20 years in prison. She was the last-remaining defendant charged in this case. Three co-defendants previously pleaded guilty to the conspiracy.
The Justice Department’s Fraud Section leads the Criminal Division’s efforts to combat healthcare fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed the Medicare program for more than $24 billion. In addition, the Centers for Medicare & Medicaid Services (CMS), working in conjunction with the Office of the Inspector General (OIG) for the Department of Health and Human Services (DHHS), are taking steps to hold providers accountable for their involvement in healthcare fraud schemes.
Compliance Perspective
Issue
According to F755, facilities must provide pharmaceutical services (including procedures that ensure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals) to meet the needs of each resident. Facilities must employ or obtain the services of a licensed pharmacist who provides consultation on all aspects of the provision of pharmacy services in the facility, establishes a system of records of receipt and disposition of all controlled drugs in sufficient detail to enable an accurate reconciliation, and determines that drug records are in order and that an account of all controlled drugs is maintained and periodically reconciled. Regulations require that the facility have a system to account for controlled medications’ receipt and disposition in sufficient detail to enable an accurate reconciliation, and that the facility conduct a periodic reconciliation. F761 says that facilities must provide separately locked, permanently affixed compartments for storage of controlled drugs listed in Schedule II of the Comprehensive Drug Abuse Prevention and Control Act of 1976 and other drugs subject to abuse, except when the facility uses single unit package drug distribution systems in which the quantity stored is minimal and a missing dose can be readily detected.
Discussion Points
- Review policies and procedures regarding the management of controlled substances in order to prevent loss, diversion, or accidental exposure.
- Train staff regarding the required documentation of and accounting for controlled medications prescribed and administered to residents, and to report any suspected incident of diversion to a supervisor or through the Hotline.
- Periodically audit to ensure that all controlled substances are accounted for each shift, and that proper documentation of controlled substances has occurred. Compare controlled substance sign-out logs with Medication Administration Records and progress notes to determine that accurate recording has occurred. Interview residents to determine that their comfort level is in keeping with expectations based on physician orders for pain relieving drugs. Thoroughly investigate and respond to any identified concerns. Your consultant pharmacist can be included in this effort.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
