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PharMerica to pay $31.5 million to settle narcotics fraud case

Federal lawsuit claims it dispensed oxycodone, fentanyl and other narcotics without valid prescriptions and submitted false claims to Medicare.

Susan Morse, Senior Editor

Kentucky-based pharmacy services business PharMerica will pay $31.5 million to settle a federal lawsuit that it dispensed oxycodone, fentanyl and other narcotics without valid prescriptions and submitted false claims to Medicare Part D for the drugs, according to the company and U.S. Department of Justice.Kentucky-based pharmacy services business PharMerica will pay $31.5 million to settle a federal lawsuit that it dispensed oxycodone, fentanyl and other narcotics without valid prescriptions and submitted false claims to Medicare Part D for the drugs, according to the company and U.S. Department of Justice.

Kentucky-based pharmacy services business PharMerica will pay $31.5 million to settle a federal lawsuit that it dispensed oxycodone, fentanyl and other narcotics without valid prescriptions and submitted false claims to Medicare Part D for the drugs, according to the company and U.S. Department of Justice.

PharMerica has agreed to pay $23.5 million to resolve the alleged False Claims Act violations.

It has also agreed to pay $8 million to settle the allegation that it enabled nursing home staff to order narcotics, and pharmacists to dispense them, without confirmation from a physician that the drugs were medically necessary, according to the federal complaint.

[Also: 18 charged with complicated $125 million fraud]

The government’s suit alleges that PharMerica pharmacies nationwide routinely dispensed Schedule II controlled drugs in non-emergency situations without first obtaining a written prescription from a physician, according to the Department of Justice.

Many of the prescriptions filled by PharMerica were for narcotics such as oxycodone and fentanyl, which can cause significant harm if used improperly and have a high potential for abuse, according to the government.

“Pharmacies put patients at risk when they dispense Schedule II narcotics, which have the highest potential for abuse of any prescription drug, without a valid prescription from a physician,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer of the Department of Justice’s Civil Division.

[Also: Running list of notable 2015 healthcare frauds]

However, the settlement contains no allegation that any patient was harmed, according to PharMerica.

The company also said it changed its operating policies in 2010 to enhance procedures related to the dispensing of controlled substances.

PharMerica of Louisville dispenses medications to residents of long-term care facilities. It also serves individuals receiving in-home care and patients with cancer.

[Also: CMS spent $103 billion on Medicare Part D in 2013]

The charges were originally brought by Jennifer Denk, a pharmacist formerly employed by PharMerica.  The U.S. intervened in the case. Denk, under a whistleblower provision, will receive $4.3 million as her share of the settlement, according to the U.S. District Court.

PharMerica has agreed to enter into a corporate integrity agreement with the Department of Health and Human Service’s Office of the Inspector General, to undertake internal compliance reforms and to submit federal healthcare program claims to independent review for the next five years.

Twitter: @SusanMorseHFN