Tampa – U.S. Attorney Maria Chapa Lopez announces that the United States has settled allegations that a Tampa-based compounding pharmacy, now-defunct RS Compounding, LLC, and its owner, Renier Gobea, knowingly billed TRICARE excessive prices for compounded prescriptions. In reaching this settlement, the parties resolved allegations that, between January 1, 2012, and January 31, 2014, Gobea and RS Compounding charged TRICARE at least 2,000 percent more for drugs than they charged cash-paying customers, in violation of the False Claims Act.
TRICARE, the health care program for uniformed service members and their families, prohibits pharmacies from charging TRICARE more than the general public. Gobea and RS Compounding charged TRICARE vastly more than they charged the public, in some cases over 10,000 percent more. When Gobea and RS Compounding determined that this practice violated TRICARE policy in January 2014, they made mere prospective changes and did not return the profits secured by the overcharges. In an ability-to-pay settlement, the government agreed to accept $1.2 million to resolve these allegations.
TRICARE’s costs for compounded drugs rose from $5 million in 2004 to $514 million in 2014 and $1.75 billion in fiscal year 2015. To date, the U.S. Attorney’s Office for the Middle District of Florida has pursued numerous actions involving fraud associated with compounding pharmacies, resulting in over $57 million in settlements.
“This case is part of our long-standing efforts to hold compounding pharmacies accountable,” said U.S. Attorney Chapa Lopez. “We will continue to combat unscrupulous practices in all forms, especially those that harm or interfere with the care received by our service members and their families.”
“This settlement demonstrates the commitment of the Defense Criminal Investigative Service and its law enforcement partners to ensure that medical service providers do not unjustly enrich themselves by wasting and diverting precious taxpayer dollars. DCIS protects and preserves the integrity of TRICARE, a vital DoD program serving U.S. service members, retirees, and their families,” said Special Agent in Charge John F. Khin, Southeast Field Office.
This lawsuit was filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue on behalf of the government when they discover evidence that defendants have submitted false claims for government funds and to receive a share of any recovery. The False Claims Act also permits the government to intervene in such lawsuits, as it has done in this case. The case is captioned United States ex rel. McKenzie Stepe v. RS Compounding LLC, Renier Gobea, Case No. 8:13-cv-3150-T-33AEP (M.D. Fla.). McKenzie Stepe filed this qui tam case, and, although she passed away during the pendency of the case, her estate will receive $264,000 as part of the settlement.
The government’s complaint in this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).
The investigation was conducted by TRICARE, the U.S. Department of Health and Human Services Office of Inspector General, and the U.S. Attorney’s Office for the Middle District of Florida. It was handled by Assistant U.S. Attorneys Shea Gibbons and Sean Keefe.
The claims resolved by this settlement are allegations only, and there has been no determination of liability.