PHILADELPHIA, PA — A local pharmacy and its owners have agreed to pay over $4.6 million to resolve allegations of fraudulent Medicare and Medicaid billings, according to an announcement made Tuesday by United States Attorney Jacqueline C. Romero.
Jai Shri Krishna LLC, the current owner of Pennmark Pharmacy in Philadelphia, and Pennmark Pharmacy Inc., the former owner, are accused of billing for prescription medications that were not actually dispensed. The medications involved include high-cost drugs such as Latuda, Sprycel, Metformin Hydrochloride, Truvada, Advair Diskus, among others.
The government alleges that in some cases, Jai Shri Krishna LLC billed Medicare for high-cost formulations of medications while dispensing lower-cost formulations to beneficiaries. Jai Shri Krishna LLC and its principal pharmacist, Antim Patel, will jointly pay $3,955,173.79 to the federal government to settle these allegations.
As part of the agreement, Jai Shri Krishna LLC and Patel have also entered into an integrity agreement with the Department of Health and Human Services, Office of the Inspector General. This agreement requires them to undertake substantial compliance obligations and to contract with an independent review organization that will conduct third-party audits of their Medicare claims and drug inventory.
Pennmark Pharmacy Inc. and its principal, Engin Celik, separately agreed to pay $700,530 to resolve allegations that they were unjustly enriched through fraudulent billing practices during their period of ownership.
In a statement, U.S. Attorney Romero emphasized the responsibility of pharmacies and pharmacists within the medical system. “They have a responsibility not to abuse their positions for profit,” she said. “Taxpayers expect that their dollars will be spent on medications needed by Medicare and Medicaid beneficiaries.”
It is important to note that the claims resolved by these settlements are allegations only, and there has been no determination of liability.
The U.S. Department of Health and Human Services Office of the Inspector General investigated the case, with Assistant U.S. Attorneys Elizabeth L. Coyne and Rebecca S. Melley and Auditor George Niedzwicki handling the proceedings.
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