Fraud During The Purchase Or Sale Of A Pharmacy
The purchase or sale of a pharmacy comes with many responsibilities and may also come with some consequences. Like many other businesses, there are certain regulations that must be followed in order to operate a pharmacy and obligations that may carry over from the previous owner.
Not only must you follow regulations, but it will also be important that the previous owner followed regulations. When purchasing an already existing pharmacy, there are possibilities that pending violations could follow with the purchase, and you could be affected.
Part of being the owner of a pharmacy includes being regulated by state and federal healthcare fraud statutes. Even further, there are licensures and certifications that you must maintain in order to operate your business.
If you are looking to purchase or sell a pharmacy, contact a qualified attorney today. It is critical to be aware of all of the included consequences.
Health Care Fraud Statutes That Apply To Pharmacies
When you purchase a pharmacy, there is a possibility that the previous owner’s actions could result in penalties against you.
While it may seem odd that you would have to pay the consequences for another person’s actions, you will have to make sure and clarify liabilities in your purchase agreement.
Below are a few healthcare statutes that apply to pharmacies with explanations of how they could apply to your purchase of a pharmacy.
Anti-Kickback 42 U.S.C. 1320a-7b(b)
As a pharmacy, essentially most of your business comes from referrals. This is because patients are given prescriptions and your pharmacy fills those prescriptions. However, if there are certain agreements for additional money or for you to fill false prescriptions, those agreements are prohibited and deemed illegal.
The anti-kickback statute looks at referrals that are made in exchange for services or goods (or payment for making such referrals). It regulates those referrals made when you have close family ties or financial relationship.If you are accused of violating the anti-kickback statute, to be found guilty, your accuser must prove that you knowingly and willfully engaged in activities surrounding the exchange of referrals for money or goods.
Health Care Fraud 18 U.S.C. § 1347
Pharmacies can also be accused of healthcare fraud in instances when they made a claim for a healthcare benefit refund when they did not provide the services they are claiming. When making these claims, the statute will also apply for claims of goods needed that were not actually used.
To prove that you have committed healthcare fraud, your accuser must prove certain things. Your accuser is required to prove that you intentionally defrauded a healthcare program, and you did so purposely to receive a refund, reimbursement, or benefit from that healthcare benefits program.
False statements relating to healthcare matters 18 U.S.C. § 1035
Because a big part of your daily responsibilities includes filling out forms and submitting them, there are laws that require you to fill them out honestly and accurately. As a pharmacy, the statements your employees make in relation to the healthcare services are also regulated.
This statute focuses on how your pharmacy documents things like filling a prescription, tracking inventory, discarding prescriptions, prescriptions that need to be and returned, and forms for ordering prescriptions.
Your pharmacy will also be regulated by civil statutes in addition to the criminal statutes explained above.
How These Statutes Apply To Your Purchase Of A Pharmacy
The way that this statute could apply to your purchase of an already existing pharmacy would likely be due to the fact that the pharmacy had received goods in exchange for a referral.
If the pharmacy received a good and the good would still physically be in the pharmacy, there is a possibility that the good may be taken based on a lawsuit against the previous owner.
When entering into your contract for the sale or purchase of a pharmacy, you will need an experienced attorney to review the terms. Certain terms of the contract will require that with your new purchase, you will take over any pending actions against the pharmacy. The terms could also say that you have accepted responsibility to pay any future restitution for legal matters from the previous owner.
What To Do If The Previous Owners Fraud Affects Your Pharmacy
If your pharmacy is being held accountable for the fraud of the previous owner, you may not see it coming. In any event, you should contact an experienced attorney as soon as possible.
You can try to prevent any actions against you by having an experienced attorney read over your contract. You will want them to read the contract for any terms that make you liable for lawsuits pending or unknown against the previous owner.
If an individual comes to you to pay or return items based on the wrongdoings of the previous owner, you will need to review your contract. Have an experienced attorney review the terms to see if you have to give up those items or make any payments.
Our office has a group of experienced attorneys who focus on healthcare and fraud. Contact our firm to speak with one of our attorneys about your healthcare fraud issue.