United States Settles False Claims Act Allegations Against Trinity Medical Pharmacy And Principals For More Than $2.2 Million
Tampa, FL – United States Attorney Maria Chapa Lopez announces today that Trinity Medical Pharmacy, LLC, (TMP) and several of its principals have agreed to pay the United States $2,244,270.14 to resolve allegations that TMP violated the False Claims Act by knowingly billing TRICARE and other government programs for claims generated by illegal kickbacks and by knowingly omitting material information from TMP’s application to become a certified Express Scripts provider.
The settlement relates to TMP’s marketing and sale of compounded medicine that should be uniquely tailored to an individual patient’s need and is often extremely expensive. Between 2013 and 2015, TMP, formerly located in New Port Richey, billed TRICARE seeking millions of dollars in reimbursement for compounded medicine. At the time, Krutika Patel was TMP’s president and chief executive officer, Devan Patel was the company’s chief operating officer, Jay Martinez was TMP’s national sales director, and Nicholas Petrillo was the national account director and top sales representative.
The United States alleges that TMP and these individuals knowingly sought reimbursement for compounded medicine claims generated through illegal kickbacks to patients and providers. The United States also alleges that TMP knowingly failed to disclose a material fact—COO Devan Patel’s previous felony conviction—when seeking to become an authorized provider with Express Scripts. Express Scripts is the pharmacy benefit manager for TRICARE and several carriers associated with the Federal Employees Health Benefits Program (FEHBP).
“Protecting TRICARE and other federal health care programs from fraud is a priority of the U.S. Attorney’s Office,” said U.S. Attorney Chapa Lopez. “Those who defraud TRICARE misappropriate money intended to provide quality health care to members of our military and their families. We will continue to protect those who serve our country.”
“This settlement demonstrates the effectiveness of investigations by the Defense Criminal Investigative Service and our law enforcement partners to ensure that precious taxpayer dollars are not used for unjust enrichment by fraudulent providers. DCIS protects the integrity of DoD programs by rooting out fraud, waste, and abuse which negatively impacts critical programs such as TRICARE,” said Special Agent in Charge John F. Khin, Southeast Field Office.
“I would like to commend the work of our criminal investigators, their law enforcement partners, and the U.S. Attorney’s Office for their tireless efforts on this case,” said U.S. Office of Personnel Management Acting Inspector General Norbert E. Vint. “Their excellent work safeguards the integrity of the FEHBP and serves to protect the millions of Federal employees, retirees, and dependents who benefit from the program.”
“The improper CHAMPVA billings made by Trinity Medical Pharmacy diverted funds intended for the care of Veterans who honorably served in the Armed Forces of the United States,” stated David Spilker, Special Agent in Charge, VA Office of Inspector General. “The continued oversight of the companies that do business with VA, as shown in this investigation, safeguard the integrity of VA programs and funding.”
The government’s action in this matter illustrates the emphasis on combating health care fraud, and one of the most powerful tools in this effort is the False Claims Act. Tips 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 settlement resulted from a coordinated effort by the U.S. Attorney’s Office for the Middle District of Florida; the Defense Criminal Investigative Service; the U.S. Office of Personnel Management, Office of the Inspector General; and the Department of Veterans Affairs, Office of the Inspector General. Assistant United States Attorney Lindsay Saxe Griffin led the investigation.
The claims resolved by the settlement are allegations only, and there has been no determination of liability.