Six individuals were recently sentenced for their connection to multiple health care fraud conspiracies involving kickbacks and fraudulent billings that resulted in almost $8 million in losses to federal, state, and private health insurance programs.
Mohamed Abdalla owned multiple pharmacies throughout Northern Virginia – including Medex Health Pharmacy in Falls Church and Royal Care Pharmacy in Fairfax. As owner of the pharmacies, Abdalla oversaw and executed two schemes to defraud health care benefit programs: one involving paying or receiving unlawful kickbacks for drugs and devices in violation of the federal Anti-Kickback Statute and another involving billing federal, state, and private health care benefit programs for drugs and devices that were either not medically necessary, not prescribed by a physician, or not received by the beneficiary.
More specifically, from at least January 2014 through at least the end of 2018, Abdalla paid kickbacks for the referral of prescriptions for compound medications and an expensive naloxone auto-injector device used to treat opioid emergencies. Then, Abdalla and his co-conspirators would bill federal health care programs in violation of the Anti-Kickback Statute, collecting more than $2 million from those schemes.
Abdalla and his employees also conspired to defraud federal, state, and private health care benefit programs by engaging in other schemes, including billing for prescriptions in their own names, names of family members, or names of other pharmacy employees. These prescriptions were not medically necessary and/or not prescribed by a licensed physician. Abdalla and his co-conspirators also billed for prescriptions that pharmacy customers never filled. These schemes resulted in a roughly $6.2 million loss to health care benefit programs.
All six participants have now been sentenced for their respective roles in the scheme. Abdalla received the harshest sentence of four years in prison. Others involved in the scheme and their respective sentences are detailed below.
Onkur Lal worked for Abdalla as a pharmacy technician and pharmacy intern before working as a licensed pharmacist. From January 2014 to April 2019, Lal used his specialized knowledge working for Abdalla to circumvent third party audits and investigations, resulting in millions of dollars in losses. For his role, Lal was sentenced to three years in prison.
Mohammed Tariq Amin worked as a pharmacy technician and general manager of Royal Care. From January 2015 to November 2018, Amin conspired with Abdalla and others to pay kickbacks for the referral of prescriptions of the naloxone auto-injector device, among other schemes. Amin was sentenced to two years in prison.
Daniel Tyler Walker worked as a pharmaceutical sales specialist for a pharmaceutical company. In his role, he marketed the naloxone auto-injector device that was used to treat opioid emergencies. From August 2015 to April 2017, Walker accepted kickbacks from Abdalla and Amin for the referral of prescriptions for the device, which were then billed to federal health care programs. Royal Care Pharmacy profited more than $1.2 million as a result of the scheme, of which Walker received at least $573,000 as kickbacks. Walker was sentenced to 15 months in prison and agreed to forfeit $671,790 to the United States.
Seth Michael Myers was a licensed attorney who conspired with Abdalla, another individual who was a licensed physician, and others, to accept kickbacks for the referral of compound medications that were billed to federal health care benefit programs. This went on from the spring of 2013 to mid-2016. A company created by Myers and the licensed physician was paid more than $2.5 million during the scheme. Myers has been sentenced to two years in prison.
Last, Michael Beatty worked as a licensed pharmacist at Fallston Pharmacy. He conspired with Myers and a licensed physician to pay kickbacks for the referral of expensive compound medications from roughly summer 2013 to fall 2014. Beatty was sentenced to one year and one day in prison.
“Health care providers are trusted to recommend and provide prescription medications that their patients need,” said Maureen R. Dixon, Special Agent in Charge, HHS Office of Inspector General, Philadelphia Regional Office. “Today’s sentencing shows individuals who commit fraud and pay kickbacks will be held responsible for their illegal actions. HHS-OIG and our law enforcement partners will continue to work together to investigate allegations of health care fraud and ensure the integrity of Federal programs.”