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Pharmacy Owner Pleads Guilty to Medicare Fraud

Louisiana Pharmacy Owner Pleads Guilty in $2.2 Million Medicare Fraud Scheme

medicare fraudDepartment of Justice officials said that a pharmacy owner charged with Medicare fraud has pleaded guilty to the charges related to a $2.2 Medicare fraud scheme.

On Thursday, April 24th, 47-year-old Mona Carter pleaded guilty to one count of Medicare fraud. Reportedly, she admitted to causing $2,245,515 in fraudulent Medicare billings for medications between January 2008 and February 2013.

Carter owned Community Pharmacy 1 in Baton Rouge, where she reportedly repackaged used drugs and resold them while billing Medicare for the prescriptions. She allegedly paid her clients’ employees including nursing homes and mental health facilities, to collect and return unused drugs, which constitutes kickbacks. She told her employees to repackage the drugs, then hand them out to patients as though the drugs were new.

She pleaded guilty to the Medicare fraud charges in a federal courthouse in Baton Rouge, Louisiana. She will be sentenced at a later date. Prosecutors have not said what type of sentence they will ask for.

Whistleblower Protections and Medicare Fraud Claims

Qui Tam” are the first words of a Latin clause referring to the plaintiff as “one who sues as much for the state as for himself or herself.”

It is a provision of the Federal Civil False Claims Act that allows a private citizen to file a suit, in the name of the U.S. Government, charging fraud by government contractors and other entities that receive or use government funds. Bolstered by amendments passed by Congress in 1986, the law has armed private citizens who have independent and direct knowledge of fraud, whether financial institution fraud or Medicare fraud, with a weapon to prosecute government contractors and others who are defrauding the Government.

In order for a qui tam lawsuit to succeed, a lawsuit must be filed with the federal government. While a person could file a qui tam case without a lawyer, such a case is unlikely to be as successful as it would be if an attorney is involved. Due to the volume of qui tam cases filed with the U.S. Justice Department (over 300 cases per year since 1996), and the limited number of Justice Department lawyers working on them, only those cases that are well presented with strong evidence are likely to be joined by the federal government. Your attorney’s primary responsibility is to help you shape the case and present it to the Justice Department.

While the U.S. Justice Department only joins about 25% of qui tam cases, the cases it does participate in are settled or won over 85 percent of the time. If the Justice Department declines to join your qui tam case, the odds of success drop to 20 percent. While this does not make the suit impossible, it does emphasize the importance of using an attorney from the beginning to present the government with the strongest case possible.

Common whistle blower actions include:

  • Medicare fraud,
  • defense contractor fraud, and
  • other kinds of fraud against state or federal government

Qui tam lawsuits have been, and continue to be, a very effective and successful tool in combating government procurement and program fraud.

The Strom Law Firm Can Help Protect Medicare Fraud Whistleblowers with the False Claims Act

If you are personally aware of a fraud that has been committed by your current or former employer, a competitor or otherwise, from tax evasion to Medicare fraud, contact the Qui Tam attorneys at the Strom Law Firm today for a no cost consultation to discuss the facts of your case and whether filing a qui tam may be appropriate. We understand the complexity of the False Claims Act, and can help you with your case. We offer free, confidential consultations so contact us for help today. 803.252.4800.



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