California Attorney General Rob Bonta announced a $925,000 settlement agreement with LASR Enterprises, a Southern California pharmacy accused of defrauding California’s Medicaid program, Medi-Cal. The agreement resolves allegations that the Palm Springs-based pharmacy and its owners unlawfully sought and received reimbursement from Medi-Cal for drugs that it over-dispensed, or that it dispensed drugs without receiving a valid prescription. The California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA) investigated the case and negotiated the settlement, which recovers more than five times the amount lost by Medi-Cal.
“The Medi-Cal system supports our communities by providing access to free or affordable healthcare services for millions of Californians,” said Attorney General Bonta. “When providers wrongfully claim reimbursement from Medi-Cal, they are misappropriating vital resources meant to protect the health of vulnerable families. Today’s settlement demonstrates our commitment to protecting the integrity of Medi-Cal and holding accountable those who try to defraud it.”
DMFEA began its investigation in this case after being alerted by the California Department of Health Care Services to LASR’s pattern of allegedly unlawful billing. Investigators found that between January 2015 and December 2017, LASR and its owners sought and received a total of $155,709 in reimbursement from Medi-Cal for drugs dispensed without a valid prescription, and a total of $22,177 in reimbursement for drugs that were over-dispensed per an authorized prescription. Their actions allegedly violated the California False Claims Act.
The settlement negotiated by DMFEA amounts to a total of $925,000 and recovers over five times the damages to the Medi-Cal program. Of the total settlement, California will receive $555,000 and the United States will receive $370,000, as Medi-Cal is funded jointly by state and federal governments.
DMFEA receives 75% of its funding from HHS under a grant award totaling $53,792,132 for federal fiscal year 2022-2023. The remaining 25% is funded by the State of California. The federal fiscal year is defined as through September 30, 2023.
The claims resolved by the settlement are allegations only, and there has been no determination of liability.
DMFEA protects Californians by investigating and prosecuting those who defraud the Medi-Cal program as well as those who commit elder abuse. These settlements are made possible only through the coordination and collaboration of governmental agencies, as well as the critical help from whistleblowers who report incidences of abuse or Medi-Cal fraud at oag.ca.gov/dmfea/reporting
Original source can be found here.