Was this Doctor M?

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Sparda29

Sparda29

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16,000 for a pain cream, what the hell was it made off? unicorn tears?
 
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pezdispenser said:
Same scheme, different people. Doctor M got one year and a day in federal pound me in the ass prison.

www.justice.gov

Doctor, Pharmacists, And Marketers In Compounding Pharmacy Kickback Conspiracy Sentenced

Tampa, Florida – Two pharmacists, a physician, and two marketers have been sentenced for conspiring to pay and receive health care kickbacks for prescriptions for compounded creams billed to TRICARE.
www.justice.gov www.justice.gov
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That is not too bad. Maybe they will release him early because of covid-19.
 
Why are college-educated people so stupid they think they can out-smart the government? Doctor M, only 42, not even halfway through his working career, and he threw it all away.
 
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BidingMyTime said:
Why are college-educated people so stupid they think they can out-smart the government? Doctor M, only 42, not even halfway through his working career, and he threw it all away.
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Because it is a set of odds. If M was not a narcissistic egomaniac, the Feds consider anything less than $10M to be not worth prosecuting for complex crimes without a hook or lead. If you are reasonably put together, prosecutions do not stick. Too bad he had a penchant for cars and high living that is a hook and blatantly advertising the fact. If you can do it beneath notice like most small time drug dealers, it’s just odds not attention.

That, or you go into government contracting where the big fraud happens.
 
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lord999 said:
Because it is a set of odds. If M was not a narcissistic egomaniac, the Feds consider anything less than $10M to be not worth prosecuting for complex crimes without a hook or lead. If you are reasonably put together, prosecutions do not stick. Too bad he had a penchant for cars and high living that is a hook and blatantly advertising the fact. If you can do it beneath notice like most small time drug dealers, it’s just odds not attention.

That, or you go into government contracting where the big fraud happens.
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To respond to the sentence in your post I bolded - you're not kidding. My parents know of people who went from earning $40k/yr working for construction companies to making life-changing money by applying for and being awarded government contracts. For example, a guy who had some experience working for a drywall company placed a bid on a government contract to put up drywall in a couple storage buildings on a nearby military base and was awarded $12 million to do it. The money literally changed his life; he went from being a bumbling white trash redneck to owning a Bentley, a beach house, and spending most of his time traveling. Of course, I'm not sure if this counts as an example of the gov't. contracting-related fraud you made mention of.
 
Was the only illegal thing M did the kickback with the doctors? If he just had a compounding pharmacy and hired sales reps to advertise his products, but did not kickback any percentage of sales, that remains legal right?
 
Inform me, why do yall call him Dr M? Was he on this board?
 
Dred Pirate said:
Inform me, why do yall call him Dr M? Was he on this board?
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Yes his username was doctor m I think. He was a bit of a local hero since he was a successful Indy owner. So it was doubly sad/upsetting when the news broke about him. Although hindsight being 20/20 it seems obvious now that he wasn’t 100% on the level (to put it mildly).
 
Pharmacy Kid said:
Was the only illegal thing M did the kickback with the doctors? If he just had a compounding pharmacy and hired sales reps to advertise his products, but did not kickback any percentage of sales, that remains legal right?
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I am no lawyer but I was under the impression that compounding pharmacies aren’t allow to advertise their products (although there are plenty of compounding pharmacies that do so either it is legal or it isn’t enforced).
 
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owlegrad said:
Yes his username was doctor m I think. He was a bit of a local hero since he was a successful Indy owner. So it was doubly sad/upsetting when the news broke about him. Although hindsight being 20/20 it seems obvious now that he wasn’t 100% on the level (to put it mildly).
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gotcha I don't remember him, tried to search for him, looks like his name has been removed
 
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Pharmacy Kid said:
Was the only illegal thing M did the kickback with the doctors? If he just had a compounding pharmacy and hired sales reps to advertise his products, but did not kickback any percentage of sales, that remains legal right?
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Depends on the state. In AZ, no kickback but DTP and DTC advertising and marketing for professional services is totally fine for both profession and example product except for non FDA approved uses (DMSO and laetrile) or idiot percentages to get around standard (We do 10.2% rather than 10%). MN is restricted to very few cases. CA restricts to professional services and not actual products. I think there is still non-covenant prescribing in all states outside of FDA specialty pharmacy (you can't write a prescription in such a way that only that pharmacy could make it except for those REMS that go through specialty pharmacy).
 
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Dred Pirate said:
gotcha I don't remember him, tried to search for him, looks like his name has been removed
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I actually don’t know why that happened. He had a popular thread that was something “check out my new store” or something. If I recall right he quit one of the two big box pharmacies to start his Indy. Maybe CVS but I could be wrong. I wish I could find the thread for you but I am either using the wrong search terms or it is gone.
 
owlegrad said:
I am no lawyer but I was under the impression that compounding pharmacies aren’t allow to advertise their products (although there are plenty of compounding pharmacies that do so either it is legal or it isn’t enforced).
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In all states, you can advertise yourself as a pharmacist who does professional practice to include compounding, that's your privilege as licensed. In most states, you can advertise that @owlegrad knows how to make geriatric compound products as a pharmacist specialist (professional services) and claim better quality. In a fewer states, you can give product examples, @owlegrad knows how to make geriatric butt paste. In no state unless you have an FDA product NDA, can you sell proprietary, @owlegrad sells Dr. Owlegrad's Butt Paste.
 
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TheBlaah said:
If just type in "Doctor M" in the By: Member field in the search and press enter, his posts will pop up.

Here's a link to one of his topics: Update on our store!
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I literally tried that and it didn’t work for me. But I am glad it did for you!
 
owlegrad said:
I literally tried that and it didn’t work for me. But I am glad it did for you!
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I think the trick is to press enter before the list of names begin populating.
 
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owlegrad said:
Yes his username was doctor m I think. He was a bit of a local hero since he was a successful Indy owner. So it was doubly sad/upsetting when the news broke about him. Although hindsight being 20/20 it seems obvious now that he wasn’t 100% on the level (to put it mildly).
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Yeah that is like finding out BMB is broke haha
 
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Pharmacy Kid said:
Was the only illegal thing M did the kickback with the doctors? If he just had a compounding pharmacy and hired sales reps to advertise his products, but did not kickback any percentage of sales, that remains legal right?
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When CVS gives out gift cards then it is OK but when you do it then it is a crime!
 
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What's wrong with charging a high margin for your compounds? The govt is the ******* for paying what they charged.
 
BenJammin said:
What's wrong with charging a high margin for your compounds? The govt is the ******* for paying what they charged.
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Kickbacks, however, there is a price schedule for DoD PeC formulary that was based on NDCs that are reasonable. Some pharmacies defrauded the DoD by cherry-picking NDCs and creating fake NDCs to price.

It's kind of like going to Walmart before they instituted a set of rivals for price comparison. Some people made up a sham store with fake low prices (a 720p 30 Hz 70" TV going for $300 when the Walmart price was $1800 back in 2006), then showed Walmart those fake low prices and made them price match. The pharmacy version was the opposite.

DoD is still chasing those down through three changes to how health care is run, so the office has legs. There is no statute of limitations ("tried and punished without limitation") but there is on the time and energy for that matter. My guess since there are at least 300 pharmacies that defrauded the DoD with more than $10M from my casual analysis years ago that it would be cutoff at that point unless someone was stupid enough to basically brag about it to the public. I think the only guarantee to prosecute right now is anyone who managed to do it for more than $10M while using some off-shore tax haven like Liechtenstein, Singapore, or Cayman or did the UBS Bearer Bond evasion as Treasury also has a concurring investigation.
 
owlegrad said:
Yes his username was doctor m I think. He was a bit of a local hero since he was a successful Indy owner. So it was doubly sad/upsetting when the news broke about him. Although hindsight being 20/20 it seems obvious now that he wasn’t 100% on the level (to put it mildly).
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I'm so confused. I thought doctor m was the doctor but now I realize he was the Indy pharmacist owner. I hate it when pharmacists call themselves doctor.
 
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BenJammin said:
I did but that portion is irrelevant to the point I made.
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I guess I don’t understand your point. Who is saying it is wrong to charge a high margin on your compounds? You seemed to me to be implying that is what he was arrested for but clearly I misunderstood.
 
I just find it fascinating that the DOJ always brings up how much these pharmacies charged the govt for compounds. Take away the physician kick backs and fake patient recruiting. Is that still a crime?
 
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BenJammin said:
I just find it fascinating that the DOJ always brings up how much these pharmacies charged the govt for compounds. Take away the physician kick backs and fake patient recruiting. Is that still a crime?
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I am torn on that actually. You have a point that they are the chumps for paying the claim in the first place. On the other hand the compounding pharmacies are 100% bad actors as they don’t just accidentally charge a 1000% markup. The markup alone definitely shouldn’t be criminal though, at worst they should just get a chargeback for the claims (the actual illegal actions notwithstanding obviously).
 
Every owner-run independent pharmacy probably engages into some sort of shady practice.

Not reversing insurance claims, filling iffy control scripts, waiving patient copays, billing NDCs for higher reimbursement then dispensing another etc. are most common forms of fraud.

Many people were happy about Doctor M’s misfortune, which he brought it on himself. I used to lurke here when he was posting. Reading from his post about his working days at cvs, I got the impression that he was a very smart and pretty decent individual. Whatever happened afterwards was just tragic.
 
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Chrish said:
Every owner-run independent pharmacy probably engages into some sort of shady practice.
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I can't think of any other reason how some independents manage to stay in business. If chain pharmacies are hurting so bad, how do these guys, whom I assume have less credit and tighter budgets, stay open and manage to pay their fully staffed crews if not by performing some insurance fraud here and there? I hear the complaints of DIR fees and charge backs from so many independents, yet it sounds like they're thriving especially in this downturn environment.

Makes me wonder...
 
Independents survive if they have low expenses, or they have some kind of niche. ALF, LTC, DME, etc.....
 
Chrish said:
Many people were happy about Doctor M’s misfortune, which he brought it on himself. I used to lurke here when he was posting. Reading from his post about his working days at cvs, I got the impression that he was a very smart and pretty decent individual. Whatever happened afterwards was just tragic.
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I don't remember anyone here being unhappy about Doctor M's misfortune. I do remember that people felt misled, he really talked up independent pharmacy, about how lucrative it was, and how pretty much anyone could do it....he left out the part about fraudulently billing the government.
 
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