What Compound Pharmacies Should Do in a DOL or Tricare Investigation

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We hear about new federal investigations targeting compound pharmacies on almost a weekly basis. These investigations typically focus on pharmacy executive’s relationships with physicians and marketing groups involving referrals of federally funded patients including Tricare patients whose medications are paid for by the Department of Labor (DOL). With the consequences of wrongdoing including severe civil penalties, and even imprisonment, following a criminal indictment, it is critically important for compound pharmacy executives to work with lawyers who have long records of successfully defending against Tricare and DOL charges.

About the Government’s Multi-Level Investigations

In our experience, the government pursues compound pharmacies suspected of Tricare fraud with a multi-level investigative approach. Physicians who refer DOL patients or Tricare prescriptions for compound fillings often receive audit requests from Express Scripts or other pharmacy programs. These requests often lead physicians to disclose their relationships with marketing groups and compound pharmacies. FBI and DEA agents then approach the marketing groups and current or former pharmacy staff for interviews to learn about the compound pharmacy’s operations referral sources.

What to Do if You are Being Investigated

Put Experience On Your Side

The attorneys of The Criminal Defense Firm work closely with compound pharmacies across the country to develop effective compliance programs, proactively address issues that can lead to investigations, and fend off criminal indictments. Our experience in Tricare, DOL, and Medicare audits involving compound pharmacies includes not only successfully representing pharmacies and their executives, but also prosecuting fraud cases as attorneys for the federal government.

As former prosecutors in critical governmental positions, we know exactly how the government builds its cases against compound pharmacies, and know what these pharmacies need to do in order to present a successful defense.

Use Our Emergency Defense Package

We know that in order to minimize the risks from a federal investigation, things need to happen quickly. Over the course of representing compound pharmacies, pharmacies, physicians, health care executives, toxicology groups, hospitals, physician syndications, and numerous other health care businesses, we have developed proven protocols for protecting our clients without wasting time. These protocols include our “Emergency Defense Package,” which has been featured by media outlets across the country.

The “Emergency Defense Package” allows us to quickly address inadequate and ineffective compliance programs and raise them to standards that will satisfy the Office of the Inspector General (OIG) and the Department of Justice (DOJ). In addition to providing advice, training, and documentation, we also bring in top consultants, as necessary, to address our clients needs. These include:

  • Certified Fraud Examiners, CFE
  • Certified Public Accountants, CPA
  • Billing and Coding Professionals
  • Compliance Officers
  • Former DEA Agents
  • Former Pharmacy Board Enforcement Officers
  • Former FBI Supervisory Special Agents

More About The Criminal Defense Firm

The Criminal Defense Firm is a health care fraud defense law firm. Our attorneys are intimately familiar with all aspects of the complex health care laws and regulations that apply to compound pharmacies, and many of our attorneys have served the Department of Justice in critical health care law positions.

Since there are few attorneys who are as well-versed in all of the nuances of health care law and who have this insider knowledge, compound pharmacies nationwide contact us to inquire about our services. We have represented clients from:

  • San Francisco, CA
  • Los Angeles, CA
  • San Diego, CA
  • Portland, OR
  • Albuquerque, NM
  • New York, NY
  • Newark, NJ
  • Denver, CO
  • Colorado Springs, CO
  • Cheyenne, WY
  • Dallas, TX
  • Tyler, TX
  • San Antonio, TX
  • Houston, TX
  • Washington, DC
  • And many more.

Recent Success Stories

The following is just a small sampling of our recent success stories:

  • Tricare Fraud Investigation against Laboratory (Department of Defense)

Result: No civil or criminal liability, case dismissed.

  • Tricare Fraud Investigation against Laboratory (Department of Justice)

Result: No civil or criminal liability, case dismissed.

  • Tricare Fraud Investigation against Laboratory (Department of Defense)

Result: No civil or criminal liability, case dismissed.

  • Tricare Fraud Investigation against Marketing Group (Department of Defense)

Result: No civil or criminal liability, case dismissed.

  • Tricare Fraud Investigation against Laboratory (Department of Defense)

Result: No civil or criminal liability, case dismissed.

  • Medicaid Fraud Investigation against fmr. CEO (Attorney General)

Result: No civil or criminal liability, case dismissed.

  • Medicare Fraud Investigation against Laboratory (OIG)

Result: No civil or criminal liability, case dismissed.

  • Investigation against Health care Provider (OIG)

Result: No civil or criminal liability, case dismissed.

  • Investigation against Health care Provider (U.S. Attorney’s Office)

Result: No civil or criminal liability, case dismissed.

  • Investigation against DME Company (Dept. Health & Human Services)

Result: No civil or criminal liability, case dismissed.

Schedule a Free, Confidential Case Evaluation at The Criminal Defense Firm

If your compound pharmacy is facing a federal investigation, or if you are being audited or are concerned that you may be audited because you do not have a comprehensive compliance program in place, we invite you to contact us for a free, confidential consultation. To speak directly with one of our experienced health care fraud defense lawyers, call 866-603-4540 or submit our evaluation form today.

This information has been prepared for informational purposes only and does not constitute legal advice. This information may constitute attorney advertising in some jurisdictions. Reading of this information does not create an attorney-client relationship. Prior results do not guarantee similar future outcomes. The Criminal Defense Firm is a Texas firm with headquarters in Dallas.
Dallas 214-817-2053
Houston 713-454-7814
Detroit 313-634-0925
Baton Rouge 225-269-8749
New York 332-239-7345
Winter Park 407-890-0460
Miami 786-751-3247
Portland 207-222-7742
Nationwide 866-603-4540