Southern California Man Accused of Health Care Fraud
PORTLAND, Ore.—A southern California man who owned and operated local compounding pharmacies has been indicted by a federal grand jury on allegations that he submitted dozens of fraudulent patient attestations in support of reimbursement claims to CVS Caremark, a national pharmacy benefit manager.
Matthew Hogan Peters, 36, of Dana Point, California, made an initial appearance today in federal court before U.S. Magistrate Judge Stacie F. Beckerman. The court unsealed a two-count indictment charging Peters with health care fraud and aggravated identity theft.
According to the indictment, Peters owned and operated Professional Center 205 Pharmacy and Portland Professional Pharmacy, compounding pharmacies located in Southeast Portland. The pharmacies filled prescriptions for, among other things, compounded pain creams, a lucrative line of products. Private and federal healthcare insurance programs reimburse compounding pharmacies for such creams at rates far higher than comparable over-the-counter or bulk-manufactured medications.
CVS Caremark administered prescription drug benefits for many patients the pharmacies served. From April 1, 2014, through May 15, 2015, Peters sought reimbursements of more than $3.4 million from CVS Caremark, which in turn paid him nearly $1.69 million. In mid-2015, CVS Caremark audited Professional Center Pharmacy’s claims for reimbursement and identified approximately 185 claims that lacked records proving customers’ receipt of medications.
Facing possible suspension from CVS Caremark’s network, Peters submitted documentation to explain the discrepancies identified in the audit. This documentation included 41 written attestations, each purporting to bear the electronic signature of an individual patient, confirming that the patient received the prescription in question. Peters is alleged to have created each of their electronic signatures himself.
Peters was released pending a four-day jury trial scheduled for May 5, 2020, before Chief U.S. District Court Judge Marco A. Hernandez.
This case was investigated by the FBI, the Offices of Inspectors General for the Departments of Health and Human Services and Labor, the United States Postal Service Office of Inspector General, the United States Postal Inspection Service, and the Defense Criminal Investigative Service. It is being prosecuted by Ryan W. Bounds and Seth D. Uram, Assistant U.S. Attorneys, and Elizabeth Ballard Colgrove, Special Assistant U.S. Attorney, for the District of Oregon.
An indictment is only an accusation of a crime, and a defendant is presumed innocent unless and until proven guilty.
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