Billing Fraud

The United States’ alleges that CareMed made false statements to insurance companies to secure prior authorization for the coverage of drugs by, among other things, fabricating Medicare beneficiaries’ medical information and posing as representatives of prescribing physicians’ offices when calling insurers.

The Complaint also alleges that CareMed engaged in double-billing by re-stocking unused dosages of Procrit and Rituxan, and then re-selling the drugs and re-billing insurance companies that provide prescription drug coverage to Medicare beneficiaries or Medicaid.

In addition, the Complaint alleges that CareMed submitted false claims for payment for automatic refills of Procrit and Rituxan that were not actually received by patients and their doctors. The lawsuit seeks damages and penalties under the False Claims Act.

Preet Bharara, the United States Attorney filed a civil fraud lawsuit  “CareMed”, a New York-based pharmacy that sells high-cost specialty drugs used to treat conditions that require complex treatment, such as cancer.

the United States has settled the claims against CareMed pursuant to a settlement stipulation approved today by U.S. District Judge Denise L. Cote. In the settlement.

It is time to clean up the fraud. You must read your copy of billing. Just a thought.