A man from southern California who owned and ran local compounding pharmacies has been charged by the state grand jury on claims that he tabled dozens of improper patient testimonies in support of compensation claims to CVS Caremark, a nationwide pharmacy benefit manager.
Matthew Hogan Peters, of Dana Point, California, age 36, made his first appearance today before Judge Stacie F. Beckerman, U.S. Magistrate federal court. The court opened a two-count allegation charging Peters with health care fraud and stolen identity theft.
According to the allegations, Peters owned and run compounding pharmacies located in Southeast Portland; Professional Center 205 Pharmacy and Portland Professional Pharmacy. The pharmacies filled prescriptions for a gainful line of products such as compounded pain creams, among other things. Private and state healthcare insurance plans compensated compounding pharmacies for such products at speeds far higher than comparable average over-the-counter or mass produced medications.
CVS Caremark dispensed prescription drug benefits for several patients the pharmacies assisted to. From April 1, 2014, to May 15 2015, Peters sought compensation of over $3.4 million from CVS Caremark, which in turn remitted to him approximately early $1.69 million. In mid-2015, CVS Caremark examined Professional Center Pharmacy’s claims for compensation and pointed out close to 185 claims that were missing records demonstrating that the customers received the drugs.
Facing a probable ban from CVS Caremark’s network, Peters tabled records to explain the inconsistency pointed out in the audit. This documentation was made up of 41 written testimonies, each claiming to have the electronic signature of a single individual patient, ascertaining that the patient collected the prescription in question. Peters is said to have generated each of their electronic signatures by himself.
Peters was freed awaiting a four-day jury trial set for May 5, 2020, before Marco A. Hernandez, Chief U.S. District Court Judge.
The FBI, the United States Postal Service Office of Inspector General, the Offices of Inspectors General for the Departments of Health and Human Services and Labor, the United States Postal Inspection Service, and the Defense Criminal Investigative Service investigated the case. Assistant U.S. Attorneys, prosecuting the case are Ryan W. Bounds, Seth D. Uram, and Special Assistant U.S. Attorney, for the District of Oregon, Elizabeth Ballard Colgrove.
An allegation is only an accusation of a crime, and the accused is assumed to be innocent unless and until proven guilty beyond a reasonable doubt.
Do you know of any person or medical practitioner involved in such schemes? If you do, don’t hesitate to seek legal advice. Healthcare fraud is a serious crime. If you or anyone you know has been a victim any of the above situations or know of any entity swindling the healthcare program, our Healthcare Fraud Group is more than ready to offer you help. We can offer assistance in legal matters relating to healthcare fraud. We are committed to offering you the help that you need in dealing with legal matters. Reach us now at 888-402-4054.