The United States Attorney’s Office for Southern District of Florida has recently announced a settlement with three Florida pharmacies to resolve allegations that they fraudulently used collaborative practice agreements (“CPAs”) to bill federal health care programs for unlawfully prescribed medications.
In its press release, the governments explains that “A collaborative pharmacy practice agreement is a written agreement between a physician and pharmacist that allows the pharmacist to provide specific patient care services for chronic health conditions to the physician’s patients. Services provided by the pharmacist are outlined in the written agreement and must be in accordance with Florida law.”
The settlement explains that the pharmacies used:
– CPAs that were unlawful pursuant to Florida law because they delegated prescribing authority from a physician to a pharmacist, and
– the same CPAs to write and fill prescriptions without any physician involvement.
The complaint alleged, among other things, that the CPAs allowed pharmacists to:
– modify formulas for compounded prescriptions;
– issue initial prescriptions;
– delegate pharmacists’ tasks to technicians, who modified and billed for compounded medications.
In addition, many CPAs in the case were allegedly expired. More information on the case: United States et al. ex rel. Morales v. Habana Hospital Pharmacy, Inc. et al., No. 17-CV-80871-KAM, S.D.Fla., 2017.
This allegedly fraudulent scheme resulted in the submission of false claims to federal health care programs, including Medicare and Medicaid. To resolve the allegations, the pharmacies have settled with the government for over $831,000.
If you are using CPAs in your practice, make sure you review them on at least annual basis. It is very important that CPAs are compliant with your state laws and do not delegate more responsibilities than state law allows; and – of course – have them reviewed by your legal counsel.