BIRMINGHAM, ALABAMA – U.S. Attorney Charges NW Alabama Compounding Pharmacy Sales Representatives in Prescription Fraud Conspiracy
Two sales representatives for a Haleyville, Ala.-based compounding pharmacy, KELLEY NORRIS, also known as KELLEY NORRIS-HARTLEY, 41, of Tuscaloosa, and BRIDGET McCUNE, 41, of Destin, Fla., have been charged in a conspiracy to generate prescriptions and defraud health care insurers and prescription drug administrators out of tens of millions of dollars in 2015.
The U.S. Attorney’s Office filed separate informations charging Norris and McCune with conspiracy to commit health care fraud, wire fraud and mail fraud. McCune’s information also charges her with conspiring to solicit and receive kickbacks in return for referring prescriptions under Medicare and TRICARE, a U.S. Department of Defense health care program, and with money laundering for spending proceeds of the crimes. Both women face various counts of health care fraud for submitting fraudulent prescription reimbursement claims to Blue Cross Blue Shield of Alabama.
In conjunction with the charges, prosecutors also filed plea agreements with Norris and McCune.
“In this case, a pharmacy used a marketing scheme that increased sales of expensive medications without regard for patient need or medical necessity,” said Acting U.S. Attorney Robert O. Posey.
Norris and McCune both worked for Northside Pharmacy, an Alabama company doing business as Global Compounding Pharmacy. Global’s compounding and shipping facility was in Haleyville. The pharmacy did its prescription processing, billing and customer service at its “call center” in Clearwater, Fla.
Global hired sales representatives, including Norris and McCune, who were located in various states and were responsible for generating prescriptions from physicians and other prescribers. To bill insurance providers, including Blue Cross Blue Shield of Alabama, Medicare and TRICARE, for these prescriptions, Global contracted to enter the pharmacy networks of their third-party administrators, known as “pharmacy benefit managers” or “PBMs.” These PBMs included Prime Therapeutics, Express Scripts Incorporated and CVS/Caremark.
The court documents describe a conspiracy at Global that centered on generating and billing PBMs for fraudulent, often high-reimbursement prescriptions. To generate prescriptions, Global hired sales representatives who were married or related to doctors and other prescribers. Global also encouraged sales representatives to volunteer at doctors’ offices in an effort to build relationships and generate prescriptions.
As part of the scheme, Global sales representatives, including Norris and McCune, would often pay kickbacks to doctors and other prescribers in exchange for writing prescriptions for expensive medications. The medications were then billed to health care insurers and prescription drug administrators, with Global keeping a significant portion of the profits.
“Schemes like this defraud Medicare and other health insurance systems by pushing unnecessary medications and driving up the costs of health care,” said Posey.
KELLEY NORRIS, Conspiracy to Commit Health Care Fraud, Wire Fraud, and Mail Fraud, BIRMINGHAM, ALABAMA, 2015, Charges Filed, No Sentence Yet.
Key Facts
- State: Alabama
- Category: Health Care Fraud
- Source: DOJ Press Release â†â€â€
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