On behalf of the entire Allegiant Experts team, we hope that this week’s blog finds you in good health and high spirits. As we collectively continue to contend with the coronavirus pandemic, we wish to remind you that our team remains committed to assisting its clients. We’re working remotely but are still available to speak with you. Please don’t hesitate to call us at 407-217-5831 or email us at info@allegiantexperts.com.
In an effort to not further inundate you with COVID-19 news, for the time being, we would instead like to remind you that our fight against health care fraud continues. Now, more than ever, our health care system requires our support. Manipulating it for greed is an egregious crime. Dr. Andrew M. Berkowitz of Huntington Valley, Pennsylvania discovered this last when he had new health care fraud charges levied against him.
Berkowitz faces a new civil lawsuit.
As reported by the Eastern District of Pennsylvania branch of the United States Department of Justice, a new civil lawsuit has been brought against Berkowitz for engaging in health care fraud and improperly distributing and dispensing controlled substances. The civil complaint relates to criminal charges that were previously filed against him and for which he has pleaded guilty.
The doctor “has also agreed to pay a total of $2.8 million in civil damages and penalties under the False Claims Act, Controlled Substances Act, and in civil forfeiture, committed to never obtaining another controlled substance registration, and consented to a 20-year exclusion from Medicare and Medicaid. The consent judgment remains subject to court approval,” the DoJ reports.
Berkowitz developed a “goodie bags” scheme.
Through his health care practice and employees, Berkowitz created a scheme that involved his business dispensing prescription drugs which included controlled substances. They were all placed in what his staff called “goodie bags”. Every patient whose insurance would cover the drugs he had in stock would receive these bags. Berkowitz’s objective was to dispense the drugs for profit without any assessments of medical necessity or whether the drugs were needed for legitimate medical purposes.
“For each ‘goodie bag’ dispensed, Berkowitz allegedly submitted claims for reimbursement falsely asserting that the drugs were medically necessary for the patient,” reads the DoJ report, “Berkowitz also allegedly prescribed oxycodone to ‘pill-seeking’ patients in exchange for submitting excessive claims to patients’ insurance, including Medicare, for medically unnecessary prescription drugs and for services not rendered.”
Berkowitz previously pleaded guilty to criminal charges on January 24, 2020.
In addition to paying $2.8 million in civil damages and penalties under the False Claims Act, Controlled Substances Act, and in civil forfeiture, Berkowitz has also agreed to pay $3.5 million in criminal restitution. He is also prevented from prescribing, distributing or dispensing any controlled substances in the future. In addition, Berkowitz cannot ever seek another controlled substance registration from the Drug Enforcement Administration. As well, he faces a 20-year exclusion from Medicare and Medicaid.
Michael J. Driscoll is the Special Agent in Charge of the FBI’s Philadelphia Division. “Andrew Berkowitz pushed unnecessary pills on his patients and doled out opioids to addicts,” he is quoted as saying in the report, “All the while, he was billing Medicare and insurance companies for it and making multiple millions. It’s a gross violation of both medical ethics and federal law. Alongside the criminal case, these civil actions should help hammer home to the medical community that health care fraud is a crime that truly doesn’t pay.”
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