BOSTON (USDOJ) – A Michigan pharmacist and two pharmacies agreed to pay $1 million to resolve allegations that they submitted false claims to Medicare for a drug used in rapid reversal of opioid overdoses.
Riad “Ray” Zahr, of Dearborn, Mich. and two specialty pharmacies that Zahr formerly owned and operated have agreed to resolve allegations that they submitted false claims for the drug Evzio. Evzio was a naloxone hydrochloride product used for the rapid reversal of an opioid overdose. Evzio was the highest-priced version of naloxone on the market and insurers frequently required the submission of prior authorization requests before they would approve coverage for Evzio.
The United States contends that, between Aug. 1, 2017 and June 30, 2019, Plymouth Towne Care Pharmacy, Inc. d/b/a People’s Drug Store (People’s Drug Store) and Shaska Pharmacy LLC d/b/a Ray’s Drugs (Ray’s Drugs) submitted false claims for Evzio to Medicare. In particular, the government alleges that People’s Drug Store and Ray’s Drugs submitted false and misleading prior authorization requests for Evzio that contained clinical assertions for which the pharmacies lacked any factual basis. At times, Zahr and the pharmacies initiated Evzio prescriptions based on rudimentary patient lists with only basic biographical details. In the prior authorization requests, Zahr and the pharmacies also included assertions about the comparative effectiveness of Evzio purportedly authored by prescribing physicians but that...
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