NJ Pharmacy to Pay $625K For Billing For Drugs Not Dispensed

The government contends prescriptions were billed to federal healthcare programs without being dispensed.

NEWARK, N.J. – Medsinbox Pharmacy LTC LLC, doing business as Farmacia San Antonio (“Medsinbox”), has agreed to a $625,000 settlement to address allegations that it violated the False Claims Act by “knowingly billing federal health care programs for medications that it never dispensed,” Acting U.S. Attorney Vikas Khanna announced.

“Pharmacies play an important role in maintaining the safety and accuracy of prescribed medications, and allegedly billing for medications not actually dispensed undermines that role and defrauds our healthcare programs. The government will continue to pursue entities that engage in fraud and abuse at the taxpayers’ expense,” Acting U.S. Attorney Vikas Khanna.

According to the settlement agreement:

The United States alleged that, from January 1, 2019, through January 24, 2022, Medsinbox caused the submission of claims for reimbursement to the Medicare Part D Program and the New Jersey Medicaid Program for drugs that were never dispensed to beneficiaries. The government contends that inventory records showed that Medsinbox did not purchase enough of these medications from wholesalers to fill all the prescriptions billed to these federal health care programs.

Coordinated Investigation

This resolution is the result of joint efforts by the U.S. Attorney’s Office for the District of New Jersey and the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section. The government’s case was handled by Assistant U.S. Attorneys Robert Toll and Kruti Dharia of the Opioid Abuse Prevention and Enforcement Unit, and Senior Trial Counsel Jennifer Cihon in the Civil Division’s Commercial Litigation Branch (Fraud Section).

Authorities highlight that the False Claims Act remains a primary tool for pursuing allegations of fraud, waste, and abuse in federal healthcare programs.

“Health care providers defraud federal health care programs when they bill for goods or services that they did not provide,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “We will hold accountable those who improperly seek to profit from taxpayer funded programs.”

Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 1-800-HHS-TIPS (800-447-8477).

The claims resolved by the settlements are allegations only, and there has been no determination of liability.