BOSTON – Florida-based Solera Specialty Pharmacy has entered into a deferred prosecution agreement and has agreed, along with its Chief Executive Officer (CEO), to pay a $1.31 million civil settlement to resolve allegations that it submitted fraudulent claims to Medicare for Evzio, a high-priced drug used in rapid reversal of opioid overdoses.
According to the admissions of Solera and its CEO Nicholas Saraniti in the civil agreement, and Solera’s additional admissions in the criminal agreement, the pharmacy dispensed Evzio from January 2017 to May 2018. During that time, 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. Solera completed Evzio prior authorization forms in place of the prescribing physicians, including instances in which Solera staff signed the forms without the physician’s authorization and listed Solera’s contact information as if it were the physician’s. In addition, Solera submitted Evzio prior authorization forms that contained false clinical information to secure approval for the expensive drug. Finally, Solera waived Medicare beneficiary co-payment obligations for Evzio on numerous occasions without analyzing whether the patient had a genuine financial hardship.
Solera entered into a deferred prosecution agreement in connection with a criminal information charging the pharmacy with one count of health care fraud....
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