When a small pharmacy company hauls in $168.7 million in annual revenue without filling many prescriptions, the medical community takes notice. The Los Angeles Times reports that the specialty pharmacy Ven-A-Care of FL Keys, Inc., is no mere small pharmacy. The business acts as a whistle-blower that accounts the misdeeds of pharmaceutical businesses that overbill Medicare and Medicaid. Ven-A-Care, called a “professional bounty hunter” by critics, is simply working within the bounds of the law as it seeks to ease the burden on consumers who are already overtaxed by high health insurance coverage premiums. Article source – Ven-A-Care blows the whistle on Medicare fraud by Newsytype.com.
Reason for Ven-A-Care
The price paid for drugs v what is reported by the large pharmaceutical drugs to the federal government for reimbursement is what the Ven-A-Care researches. Anything that looks wrong is what Ven-A-Care is looking for, for the Federal Government. Then, a lawsuit might be filed. One example was a 2005 suit in which a 1-gram vial of an antibiotic called vancomycin was sold to pharmacies at $6.29 each, but the pharmaceutical business charged Medi-Cal $58.37. The medication atenolol was charged to Medi-Cal for $70.30 while pharmacies only paid $3.05 for 50 milligram tablets. These were reported by the LA Times. They are small examples though. The State of CA has recovered at least $95 million of late, thanks to Ven-A-Care’s efforts.
“I think Ven-A-Care has played a predominant role in alerting state and federal governments about … fraud,” said California Supervising Deputy Attorney General Nicholas Paul.
The venal meet Ven-A-Care
Ven-A-Care has been working hard since 2000. In fact, 18 health insurance coverage over-billing cases have been won since then. About $380 million has been paid to this small company for the work. About $2.2 billion has been made by the federal and state governments though in the U.S.
“(Ven-A-Care is) cleaning up a huge cesspool,” said Nevada attorney and former Medicaid fraud investigator L. Timothy Terry. “Without their efforts, taxpayers would be gouged out of I don’t know how much money.”
Putting a limit on payments made
Insiders like former federal healthcare fraud investigator Michael Loucks believe that corporations like Ven-A-Care are taking advantage of a near-limitless jackpot system. In order to keep this under control however still get the cases made, defense attorney Loucks suggests that a $2 million limit ought to be put in place, reports the Times. Ven-A-Care attorney Jim Breen sees caps as too prohibitive. A large return has to be paid out due to the amount of just legal costs that comes when pursuing big pharmaceutical drugs while Ven-A-Care’s legal team works with the federal government.
Articles cited
Los Angeles Times
latimes.com/news/nationworld/nation/la-na-whistle-blower-20110124,0,5954723.story
Posted in Uncategorized | 
Tags: