Physicians, Pharmacists Charged in Major Multi-Million Dollar Kickback Scheme


California’s insurance commissioner charged 26 doctors, pharmacists and business owners for participating in a $40 million fraudulent billing and kickback scheme.

California’s Department of Insurance claimed the defendants fraudulently billed insurers from 2011 to 2015 for medications and creams that were not approved by the U.S. Food and Drug Administration. All in all, more than 13,000 patients and 27 insurers were affected by the scheme, the agency said.

Tanya Moreland King and Christopher King, owners of three medical billing and management companies, made arrangements with physicians to pay them each time they prescribed a cream,

medication or urine test, even though they weren’t medically necessary.

The doctors were given a $50 share of the profits. The Kings purchased the creams for about $15 to $40 per tube, but billed worker’s compensation insurers $250 to $700 per tube. They also conspired with two pharmacists to sell more than $1 million of the compound creams, the department said.

The 21 doctors are charged with prescribing unnecessary medications and tests to patients in order to receive kickbacks, according to the state agency.

“The Kings and their co-conspirators played with patients’ lives, buying and selling them for profit without regard to patient safety,” said Commissioner Dave Jones. “Patients have the right to expect treatment decisions by healthcare professionals are based on medical need and not unadulterated greed. The magnitude of this alleged crime is an affront to ethical medical professionals.”

(Source: Maria Castellucci , Modern Healthcare [4/18/2017])