What's the catch here?

[Sparda29]

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Someone I barely know as an acquaintance contacts me and is trying to talk me into being the SP at a pharmacy they want to open. The person is not a pharmacist, just owns a couple of bars, car wash, etc.

He's saying he'll give me a salary + 20% profit + insurance/benefits. (No investment on my part other than putting my name down as SP.)

What's the catch here? He's saying he's opening it in a neighborhood that is becoming gentrified via yuppies, got a 15 year lease on a nice location, and that he knows a HIV clinic operator in the area who says he will send as many patients as we can handle.

What's been done so far is:

Building has been leased.
Shelving people have been in to look at the location.
Supplier has been found (Kinray) and they'll be giving us an 80k inventory debit or something.

What needs to be done is finding a SP and completing registration, getting contracts for Medicare, Medicaid, etc. Computer, computer system (most likely Micromerchant/Prime Rx), phones, other equipment.

Two people I've talked to about this told me to look into it but be very careful/wary because they think these guys might be trying to scam me into being the SP while they commit Medicaid fraud and they'll run away with the money and leave me as the scapegoat for the operation.

Maybe have a lawyer draw up a contract saying that any pharmacy decisions cannot be made without my consent. Any illegal activities done by other personnel do not fall upon me, etc?

 

[type b pharmD]

Someone I barely know as an acquaintance contacts me and is trying to talk me into being the SP at a pharmacy they want to open. The person is not a pharmacist, just owns a couple of bars, car wash, etc.

He's saying he'll give me a salary + 20% profit + insurance/benefits. (No investment on my part other than putting my name down as SP.)

What's the catch here? He's saying he's opening it in a neighborhood that is becoming gentrified via yuppies, got a 15 year lease on a nice location, and that he knows a HIV clinic operator in the area who says he will send as many patients as we can handle.

What's been done so far is:

Building has been leased.
Shelving people have been in to look at the location.
Supplier has been found (Kinray) and they'll be giving us an 80k inventory debit or something.

What needs to be done is finding a SP and completing registration, getting contracts for Medicare, Medicaid, etc. Computer, computer system (most likely Micromerchant/Prime Rx), phones, other equipment.

Two people I've talked to about this told me to look into it but be very careful/wary because they think these guys might be trying to scam me into being the SP while they commit Medicaid fraud and they'll run away with the money and leave me as the scapegoat for the operation.

Maybe have a lawyer draw up a contract saying that any pharmacy decisions cannot be made without my consent. Any illegal activities done by other personnel do not fall upon me, etc?

Yes. As SP (which I am assuming is the NY version of PIC or Pharmacist Manager) you will be the #1 person responsible for all matters pertaining to pharmacy law. I would not only get some protection in writing, I would have a frank conversation with the owner about the scope of pharmacy law and SP responsibilities, so they know that you legally need to keep an eye on their operations. It is possible that since you likely have a reputation as a pretty laid back dude, that these people are hoping you may look the other way on something. You can't, and you have to let them know that.

20% profit sounds almost too good to be true if you *only* have to do SP duties. I personally would make sure the owner doesn't expect you to do things like contracting, supervision and maintenance of the software, advertising, setting fees and rates, and doing general business stuff. Let them keep the liability for all of that.

Even if it is a scam operation, if you are limited to performing professional and rx SP discretionary functions, you can cover your butt on the day to day, but make sure to have a backup plan if the op indeed folds quickly.

Do you have knowledge of the neighborhood, patient base, and insurers in that area? I would also want to do my own due diligence in order to determine professionally if the place is going to work out. If it's a situation where you would open that pharmacy if you could (ie had the capital) , then go for it! Anything less and it would be wise to be skeptical.

 

[BMBiology]

Maybe have a lawyer draw up a contract saying that any pharmacy decisions cannot be made without my consent. Any illegal activities done by other personnel do not fall upon me, etc?

It doesn't matter what you have in writing. If the pharmacy is commiting fraud, even without your knowledge, you may still be held liable. You are the SP. You are in charge. Not knowing what others are doing with your pharmacy is not an acceptable excuse. If you are blacklisted by medicare, you are pretty much unemployable because they can't bill for your service.

Ask yourself...if you are a business owner with this amount of resources, wouldn't you want your SP to have more experiences? someone who has already operated a pharmacy? With what they are offering, they can hire anyone...so why you? why are you so lucky?

 

[group_theory]

What's the catch here? He's saying he's opening it in a neighborhood that is becoming gentrified via yuppies, got a 15 year lease on a nice location, and that he knows a HIV clinic operator in the area who says he will send as many patients as we can handle.

Just be careful that your friend don't violate any federal laws, especially Stark Laws since what is acceptable practices/habits in most business may not be in the healthcare field. If the HIV clinic operator is getting incentives to refer patients to your pharmacy (whether financial or otherwise), it may be a Stark violation (and penalties can be hefty)

Something else to keep in mind - contracts are between you and the signing party only - it does not absolve you from your obligations in the eyes of the law. If there are DOH or OSHA or CMS violation (and the DOJ goes after you) - having a contract saying that you are not responsible does not negate your responsibility. Also keep in mind that ethical violations (such as willfully ignoring evidence of fraud) may put you in hot waters with the state board of pharmacy as well. And if there is a disgruntle employee who discovers the financial windfall (from the whistleblower act) goes to the feds ... and tells them that you are involved (whether or not you are truly involved) ... you are screwed. Also keep this is mind if you are the SP ... respondant superior. Any actions of your employees will fall on you.

Plus why would someone whom you barely know, who also barely knows you ... be that eager to give you the helm of a brand new pharmacy? Why not find someone who has more experience starting or running an independent pharmacy? If it's too good to be true ... caveat emptor.

Before proceeding, please do your due diligence and get professional assessment (ie getting a lawyer who is knowledgeable in the field, as well as an accountant/CPA who deals with these type of healthcare transaction) to go over the agreement and weigh the pros and cons. Don't end up as a character on CNBC's American Greed.

 

[Sparda29]

It doesn't matter what you have in writing. If the pharmacy is commiting fraud, even without your knowledge, you may still be held liable. You are the SP. You are in charge. Not knowing what others are doing with your pharmacy is not an acceptable excuse. If you are blacklisted by medicare, you are pretty much unemployable because they can't bill for your service.

Ask yourself...if you are a business owner with this amount of resources, wouldn't you want your SP to have more experiences? someone who has already operated a pharmacy? With what they are offering, they can hire anyone...so why you? why are you so lucky?

Reasons he gave:

Other people want higher salary. They want someone young like them and the same ethnicity/religion also.

He asked me about what went on at the Bronx pharmacy that got shut down last year for fraud and I pretty much explained to him what happened and how ****ed up it was for them to be doing that and that I am not interested in anything that involves that.

 

[Sparda29]

Just be careful that your friend don't violate any federal laws, especially Stark Laws since what is acceptable practices/habits in most business may not be in the healthcare field. If the HIV clinic operator is getting incentives to refer patients to your pharmacy (whether financial or otherwise), it may be a Stark violation (and penalties can be hefty)

Something else to keep in mind - contracts are between you and the signing party only - it does not absolve you from your obligations in the eyes of the law. If there are DOH or OSHA or CMS violation (and the DOJ goes after you) - having a contract saying that you are not responsible does not negate your responsibility. Also keep in mind that ethical violations (such as willfully ignoring evidence of fraud) may put you in hot waters with the state board of pharmacy as well. And if there is a disgruntle employee who discovers the financial windfall (from the whistleblower act) goes to the feds ... and tells them that you are involved (whether or not you are truly involved) ... you are screwed. Also keep this is mind if you are the SP ... respondant superior. Any actions of your employees will fall on you.

Plus why would someone whom you barely know, who also barely knows you ... be that eager to give you the helm of a brand new pharmacy? Why not find someone who has more experience starting or running an independent pharmacy? If it's too good to be true ... caveat emptor.

Before proceeding, please do your due diligence and get professional assessment (ie getting a lawyer who is knowledgeable in the field, as well as an accountant/CPA who deals with these type of healthcare transaction) to go over the agreement and weigh the pros and cons. Don't end up as a character on CNBC's American Greed.

The only thing the operator of the HIV clinic wants is that he wants us to give his patients some freebies like free toothpaste, toothbrushes, soap, shampoo, etc.

 

[type b pharmD]

Reasons he gave:

Other people want higher salary. They want someone young like them and the same ethnicity/religion also.

He asked me about what went on at the Bronx pharmacy that got shut down last year for fraud and I pretty much explained to him what happened and how ****** up it was for them to be doing that and that I am not interested in anything that involves that.

The fact that he asked you about the other pharmacy's fraud is suspicious. If I was going to open up a scam pharmacy, first thing I'd do would be to find out how everyone else got caught

 

[type b pharmD]

The fact that he asked you about the other pharmacy's fraud is suspicious. If I was going to open up a scam pharmacy, first thing I'd do would be to find out how everyone else got caught

Although less so if the new shop is going to be in the same neighborhood.

 

[group_theory]

The only thing the operator of the HIV clinic wants is that he wants us to give his patients some freebies like free toothpaste, toothbrushes, soap, shampoo, etc.

I think this is illegal under Medicare/Medicaid (but I'm not a lawyer, but healthcare law is very complicated. I strongly advised you to seek legal opinion)

http://oig.hhs.gov/fraud/docs/alertsandbulletins/SABGiftsandInducements.pdf

*there are exceptions as defined by the OIG - but you should really do your homework before making any commitment.

 

[BMBiology]

Reasons he gave:

Other people want higher salary. They want someone young like them and the same ethnicity/religion also.

He asked me about what went on at the Bronx pharmacy that got shut down last year for fraud and I pretty much explained to him what happened and how ****** up it was for them to be doing that and that I am not interested in anything that involves that.

With the amount he will be spending, paying someone, who has experiences, an extra 10-20 k is well worth it.

 

[type b pharmD]

I think in this situation a few free toothbrushes are not going to be remotely close to the biggest legal risk Sparda could be taking. While technically illegal, the people who get busted for stark law violations are the ones who are inducing via cash gifts or property of significant value.

 

[BMBiology]

The only thing the operator of the HIV clinic wants is that he wants us to give his patients some freebies like free toothpaste, toothbrushes, soap, shampoo, etc.

If you are the operator, why would you go through the hassle of helping someone so your patients can free toothpaste? there are plenty of non profits where they can get these things for free.

A lof ot these fraudsters dont care about violating medicare fraud. Once they make their money, they are just going to get out of the country and live like a king for the rest of their days.

 

[type b pharmD]

If you are the operator, why would you go through the hassle of helping someone so your patients can free toothpaste? there are plenty of non profits where they can get these things for free.

A lof ot these fraudsters dont care about violating medicare fraud. Once they make their money, they are just going to get out of the country and live like a king for the rest of their days.

I was thinking along these same lines too. Free toothpaste is a joke, but it could have potentially been a test to see if the new owner would be ok to break minor laws on paper at first, with the goal of something more serious down the line.

If the op is going to be a fraud, what better way to start up some business than by arranging a little casual and under the radar kickbacks to get the ball rolling.

On the other hand, it could just be a few well meaning business people looking out for each other in their neighborhood and ethnic group, with or without knowledge of legality, if they don't go beyond toothpaste then it could be seen as a reasonable and savvy business idea.

 

[Sparda29]

According to that document someone posted.

" In sum, unless a provider’s practices fit within an exception (as implemented by regulations) or are the subject of a favorable advisory opinion covering a provider’s own activity, any gifts or free services to beneficiaries should not exceed the $10 per item and $50 annual limits."

Yeah, this is what I remember the guy telling me. He said the guy wanted the patients to get like a $50 credit at the store for these kind of items.

Still, I'm very skeptical about all this. I'd rather just have one of my good friends bankroll me and go 50/50 with them later on. I'm pretty happy where I'm at right now working for the same independent owner for whom I've been working with for the last 2 years.

 

[MatCauthon]

Ancient Chinese Proverb: Never enter business arrangement with sketchy man

 

[nguyenulm]

Yea, don't do it. I got a call like this last year. I live in Texas, but dude asked me if I wanted to be a SP for a new pharmacy in Florida. Needed someone young etc. I was yea ok, and hung up.

 

[Dred Pirate]

According to that document someone posted.

" In sum, unless a provider’s practices fit within an exception (as implemented by regulations) or are the subject of a favorable advisory opinion covering a provider’s own activity, any gifts or free services to beneficiaries should not exceed the $10 per item and $50 annual limits."

Yeah, this is what I remember the guy telling me. He said the guy wanted the patients to get like a $50 credit at the store for these kind of items.

Still, I'm very skeptical about all this. I'd rather just have one of my good friends bankroll me and go 50/50 with them later on. I'm pretty happy where I'm at right now working for the same independent owner for whom I've been working with for the last 2 years.

ya - it it looks like a duck, smells like a duck, ****s like a duck, it is a duck.

He wants somebody young and eager because they think it will be easier to pull on over on you. Someone who will be to new to get what is really going on. I would venture to say there is about a 95% chance something less than on the up and up is going on.

be weary man.

 

[type b pharmD]

ya - it it looks like a duke, smells like a duck, ****s like a duck, it is a duck.

He wants somebody young and eager because they think it will be easier to pull on over on you. Someone who will be to new to get what is really going on. I would venture to say there is about a 95% chance something less than on the up and up is going on.

be weary man.

Lol . Yes.

 

[npage148]

Free toothpaste today, fake/black market HAARTs tomorrow

 

[Gombrich12]

Can you drop everything you own and be out of the country within 24 hours? If so this might be the job for you!