Pharmacy must pay $9.5 million for prescription fraud
A small pharmacy based in Overland Park will pay $9.5 million to settle a federal health care fraud lawsuit, and a Lenexa pharmacist will get $1.5 million of that for blowing the whistle on her former employer.
Emily Barnes quit in September 2015 after just five months working for Stark Pharmacy, which is located inside Menorah Medical Center in Overland Park and Research Medical Center’s Brookside location.
In that time she said she saw several types of health care fraud, including auto-filling prescriptions for a certain pain cream without patients’ consent, changing prescriptions without a doctor’s authorization and charging full price for prescriptions that were only partially filled.
The federal government intervened in her whistleblower suit, filed in November 2015. The $1.5 million is her share of the $9.5 million overall settlement Stark reached with the feds in December, according to Graves Garrett, the Kansas City law firm that represented Barnes.
The suit named as defendants Howard Stark Professional Pharmacy Inc. and the company’s three managing partners: Steven Baraban, Gary Gray and Steven Schafer, who are all licensed pharmacists. By Wednesday they had not responded to a message requesting comment the day before.
Most of the allegations in the suit relate to Baraban. He has retired, according to the Stark employee who took the phone message.
A spokeswoman for HCA Midwest, which owns Menorah and Research, said the pharmacies are not affiliated with the hospitals but rent space through a management company that owns the buildings.
The pharmacy’s namesake, Howard Stark, said he’s also not affiliated with the business, having sold it in 2000. He said that as a past president of the American College of Apothecaries, he was disappointed to see his name involved.
“I am in no way connected, financially or anything, since 2000,” Stark said Wednesday. “I’ve had no control over the quality of the practice since September of 2000. I’m proud of my name and I’m proud of my reputation.”
According to the lawsuit, a significant portion of the pharmacy’s business came from filling prescriptions for the pain cream — a mixture of lidocaine/prilocaine, lamotrigine and meloxicam. The suit estimated that the cream carried an average profit of $2,000 per prescription when billed to Medicaid.
Because of this, the suit said, the pharmacy routinely automatically refilled prescriptions for the cream whether patients wanted them or not. The pharmacy waived or reduced patient co-pays and delivery fees — also a violation of federal law — and took just the insurance reimbursements, according to the lawsuit.
Barnes also said she saw Baraban alter prescriptions without a doctor’s orders based on what was in stock at the pharmacy at the time, or what would bring in a larger reimbursement. She said that the pharmacy also sometimes filled prescriptions for one medication, but then billed Medicare and Medicaid for something similar that paid out more.
She also said that prescriptions that were billed for but not picked up were sometimes returned to the supplier for a refund without reversing the insurance claim and that Stark workers compounded medications in non-sterile conditions.