On Thursday, it was announced that a sales representative linked to a Haleyville, Alabama compounding pharmacy had pleaded guilty in federal court. The defendant was accused of participating in a conspiracy to create prescriptions and defraud insurers and drug administrators out of tens of millions of dollars. The alleged crimes too placed in 2015 when 41-year-old Bridget McCune of Destin, Florida worked for Northside Pharmacy, which was doing business as Global Compounding Pharmacy.
McCune pleaded guilty to conspiracy to commit health care fraud, four counts of health care fraud, mail fraud, wire fraud and conspiring to solicit and receive kickbacks for referring prescriptions under the Medicare and TRICARE programs. In relation to spending the proceeds of the crimes, McCune pleaded guilty to two counts of money laundering. At this time, the defendant is free on bond. She will remain free until sentencing, which has yet to be scheduled.
While McCune was associated with Global Compounding Pharmacy, the company used a “call center” in Clearwater, Florida for processing, billing and customer service activities. The company hired several sales representatives, including McCune, that were responsible for generating prescriptions. Global contracted to enter the pharmacy networks of 3rd party administrators or pharmacy benefit manages to bill insurance providers, such as Blue Cross Blue Shield, TRICARE and Medicare.
Global worked with several PBMs, including Express Scripts, CVS, and Prime Therapeutics. McCune was involved in a conspiracy to defraud PBMs by generating and billing the company for certain prescriptions. Global is accused of hiring sales representatives that had relationships with doctors and other prescribers to generate the prescriptions.
Global allegedly encourages its sales representatives to volunteer at doctors’ offices and to review patient files, before encouraging patients to use Global’s products. The agreement discusses an event in which a Global Compounding Pharmacy executive ordered sales representatives to acquire certain prescriptions. McCune obtained those prescriptions for herself and her dependents shortly thereafter.
To conceal their activities, Global is accused of splitting drug quantities and automatically refilling and billing for drugs whether or not the patient needed them. The company is also accused of frequently waiving co-pays to encourage patients to acquire and refill unnecessary medications.
McCune was added to Global’s Florida team in September of 2014. She was promoted to national field trainer in January of 2015, but continued to carry out the duties of a sales representative until she departed the company in July of 2016. According to McCune’s plea agreement, she had a close relationship with a Florida physician and this family member’s signature was used to acquire the majority of the prescriptions she obtained.
While working with Global, McCune was paid a base salary as well as a monthly commission based on her prescription quantities. She has agreed to forfeit $401,628 to the government. 41-year-old Kelley Norris-Hartley of Tuscaloosa was charged at the same time as McCune. Norris has also entered into a plea agreement with the government. The charges against the duo were brought forward after Global representative, 49-year-old Robin Gary Lowry of Columbus, Mississippi was charged with conspiracy to defraud Blue Cross Blue Shield of Alabama and Prime Therapeutics.
Lowry pleaded guilty in June and is scheduled to be sentenced on November the 7th.