A north Florida man recently was charged for his part in a $64 million scheme to pay illegal kickbacks involving pharmacies, telemedicine companies and doctors.
According to the complaint, James D. Feeley of Navarre, Fla. and his partner Mark Belter of Ohio operated a purported marketing company for pharmacies that generated signed prescriptions that its pharmacy customers could fill and for which they could seek reimbursement. It was alleged that the two, acting through their company along with other marketers found insurance beneficiaries to target for expensive medications including pain creams, scar creams, eczema creams and migraine medications.
Once identified, the marketing company allegedly cold-called the beneficiaries to get them to agree to try the medication, even if they were not medically necessary and not prescribed by their physician. They allegedly obtained the beneficiary information by purchasing “leads” from various sources including overseas call centers and data brokers.
Sales representatives, frequently high school students with no medical license or training, were hired to call beneficiaries who often were tricked into accepting the medication, according to the complaint.
According to investigators, financial records shows that Feeley and Belter paid, through their marketing company, kickbacks to telemedicine companies for each signed prescription they collected. In turn, the telemedicine companies paid kickbacks to doctors for each prescription they signed. The telemedicine companies then sent the prescriptions to pharmacies selected by Feeley and Belter, which in turn submitted claims for reimbursement to federal healthcare programs.
Once the pharmacies received reimbursement from the federal insurance programs, a portion of the proceeds were sent to the marketing company as payment for the prescriptions that it had paid the telemedicine companies to generate. In total, Feeley, Belter and the marketing company paid approximately $978,000 in kickbacks to the telemedicine company. Feeley, Belter and the marketing companies received more than $6 million in exchange for the prescription referrals.
The marketing company would pay the telemedicine company $95 for each beneficiary referred for a prescription or lab test; $100 for each referred for a durable medical equipment order and $115 for a combination of the two.
The scheme is alleged to have taken place from at least January 2016 through September 2020.
Feeley was charged with one count of healthcare fraud conspiracy which is punishable by a maximum of 10 years in prison and one count of kickback conspiracy which is punishable by a maximum of five years in prison.
The Health Law Offices of Anthony C. Vitale can assist those who are charged with healthcare fraud. We represent those charged with fraudulent billing, kickbacks and false claims, among others. For information call us at 305-358-4500 or send an email to firstname.lastname@example.org to discuss.