Pharmacy owner to pay feds $4.25 million fine

A Florida pharmacy owner has agreed to pay the federal government $4.25 million to resolve allegations that his pharmacy falsely billed the Department of Defense’s TRICARE program for millions.

Mark Gilmore, partial owner of compounding and specialty pharmacy QMedRx in Maitland, Fla., is one of several compounders who have been accused by the government of filing improper claims to the TRICARE program within the past two years. In the Middle District of Florida, the government has recovered almost $70 million in fines and penalties over the past 18 months. 

From January 1, 2013 until January 22, 2014, QMedRx knowingly billed federal healthcare programs for services that were not reimbursable, according to this statement from the United States Attorney for the Middle District of Florida.

U.S. Attorney A. Lee Bentley“The United States Attorney’s Office is committed to taking the steps necessary to protect TRICARE and other federal healthcare programs from fraud,” U.S. Attorney A. Lee Bentley, III stated.  “When healthcare practitioners violate the Anti-Kickback Statute in order to generate business, they will be held accountable.” 

The claims resolved by the settlement are “allegations only, and there has been no determination of liability,” the statement said.

Because Gilmore was a partial owner of QMedRx, the U.S. Attorney sought penalties and fines from the owners who participated in the fraud. The government is still pursuing penalties and fines from other QMedRx participants. 

QMedRx, the pharmacy division of QmedRx, Home Care Solutions, is a PCAB and ACHC accredited specialty and compounding pharmacy that services physicians and patients nationwide, according to the company’s LinkedIn page.

QMedRx specializes in transdermal therapy offering relief for pain, scar, and wound care through transdermal creams and gels, and also serves as a specialty resource for Lyme therapies, sinus care, and other infusion needs.

This settlement is part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, launched by the Attorney General and the Secretary of Health and Human Services in 2009.

“The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  Since January, 2009, the Justice Department has recovered more than $30.9 billion through False Claims Act cases, with more than $18.6 billion of that amount recovered in cases involving fraud against federal healthcare programs,” Bentley said.