$1.3 Billion Opioid/Heathcare Scam

Written by: Adam Peoples, Esq.

More than 400 healthcare providers were recently charged with taking part in a health care fraud and opioid scam totaling $1.3 billion. According to Attorney General Jeff Sessions, this was the “largest health care fraud takedown operation in American history.” Sessions also commented that the nurses, doctors, and pharmacists involved chose to “violate their oaths and put greed ahead of their patients.” Kelly Norris was among those charged.

Norris was a sales representative for Northside Pharmacy, which did business as Global Compounding Pharmacy. As charged, Global conspired to generate and bill for fraudulent and high-reimbursement prescriptions by, among other things, hiring sales representatives who were married or related to doctors and other prescribers. According to the filings, Norris was closely related to an Alabama physician who wrote a significant number of the prescriptions benefitting Norris and Global. Global also encouraged its sales representatives to push Global’s products on patients as well as obtain certain prescriptions for themselves. Norris allegedly obtained certain high-reimbursement prescriptions for herself and her dependents. Norris pleaded guilty and agreed to testify against others involved in exchange for a reduced sentence. As part of her plea agreement, Norris agreed to forfeit $287,698 to the government as proceeds of illegal activity.

These charges reflect the much larger issue of how to address the estimated 2 million U.S. citizens who are currently addicted to opioids. Health care authorities are urging doctors to cut back on prescriptions while patients demand for more. Efforts are being made in Congress to pass legislation that will help states combat the opioid epidemic, but for the foreseeable future, this problem lies at the feet of insurers and healthcare providers. Medical facilities must implement protocols and procedures to combat the inevitable suit either for over or under-prescribing. Without appropriate measures in place, healthcare providers face substantial risk of loss.