OHM Pharmacy Services, a Florida-based pharmacy also known as "Benzer" and "Auburndale," has pleaded guilty to health care fraud. The company was sentenced to one year of probation and ordered to pay $82,000 in restitution. Additionally, Benzer agreed to a settlement of $1,018,000 to resolve violations under the False Claims Act.
The pharmacy admitted to dispensing Evzio, a naloxone product used for opioid overdoses. Due to its high cost, insurers often required prior authorization requests from health care providers before approving coverage. OHM completed these forms on behalf of prescribing physicians without their authorization and submitted false information that made it appear as though physicians were submitting the information themselves. This included falsely asserting that patients had unsuccessfully used other naloxone products like Narcan.
As part of the resolution, Benzer entered into an integrity agreement with the U.S. Department of Health & Human Services Office of Inspector General (HHS-OIG). This agreement mandates measures ensuring compliance with laws regarding prior authorizations for pharmaceutical claims.
The civil settlement resolves claims brought under the False Claims Act's whistleblower provisions by a former employee of kaleo Inc., Evzio’s manufacturer. The case is titled United States ex rel. Socol v. Benzer Pharmacy Holding, LLC, et al., No. 18-cv-10050-RGS (D. Mass.). The whistleblower will receive $285,040 from the civil settlement amount.
In previous years, similar settlements were reached with kaléo Inc. for $12.7 million and other pharmacies for $1 million over false claims related to Evzio.
The announcement was made by United States Attorney Leah B. Foley; Kim Milka, Acting Special Agent in Charge of the FBI Boston Division; Roberto Coviello from HHS-OIG; along with representatives from several other federal agencies.
Assistant U.S. Attorneys Abraham R. George, Mackenzie A. Queenin, and Lauren A. Graber managed the case.
