An Orange County, California resident has agreed to pay $600,000 to the United States to settle allegations that he violated the False Claims Act by paying kickbacks for prescription referrals and submitting fraudulent claims to Medicare. The settlement was announced by Acting U.S. Attorney and Special Attorney Alina Habba.
Andrew Do owned and operated three mail-order pharmacies in Orange County between January 2016 and December 2020. According to the government, Do paid kickbacks in exchange for prescriptions for compounded topical creams, filled those prescriptions, and then billed Medicare for reimbursement. The government alleges that Do knowingly violated the Anti-Kickback Statute and caused false claims to be submitted.
One of the settlement agreements resolves allegations brought under the whistleblower provisions of the False Claims Act by Daniel Toellner. Under these provisions, private individuals can file actions on behalf of the United States and may receive a portion of any recovery. As part of this resolution, Toellner will receive up to $100,000 from the settlement related to one pharmacy operated by Do.
Acting U.S. Attorney Habba credited special agents from both the U.S. Department of Health and Human Services Office of Inspector General and the Defense Criminal Investigative Service with conducting the investigation.
Assistant U.S. Attorney David V. Simunovich represented the government in this matter.
“The investigation and 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),” according to today’s announcement.
The government clarified that these are allegations only; there has been no determination of liability.
The qui tam case is titled United States ex rel. Toellner v. Apogee Bio-Pharm Corp., et al., Civil Action No. 18-13640 (D.N.J.).
