Articles Posted in Internet Pharmacy

u_s_capitol_building.jpg WASHINGTON D.C. (May 6, 2011) – U. S. Senator Sherrod Brown (D-OH) has introduced the “Stop Trafficking of Pills Act’’ or the ‘‘STOP” Act target patients and drug dealers looking for narcotic pain medications. The Senator wants individual states to take a tougher stance in fighting Medicaid fraud where prescription medications are involved.

Last year Medicaid shelled out $820 million for prescription drugs in Ohio alone last year. Drug seekers use their Medicaid card to go from doctor to doctor and pharmacy to pharmacy, and although Florida boosts the highest number of Oxycodone prescriptions filled yearly, Ohio ranks number two. The Senator claims Oxycodone, morphine and methadone are the increasing deaths and overdoses.

Senator Brown’s bill would require patients to “lock-in” their choice of a Medicaid provider and pharmacy, which is already required in many states now. The Ohio Highway Patrol has already been targeting prescription pill couriers on Ohio’s interstates. In March alone, more than 1300 arrests were made for illegal prescription pills. One of the biggest corridors, for illegal prescriptions drugs, runs from Detroit, Michigan to southern Ohio before filtering into other states.

ca.flag.jpgIn case where it appears the governments of the Untied States and Canada to stop a practice they disfavored, created a worse problem, the originator of the Canadian internet pharmacy business model gave up his license to practice pharmacy in Manitoba, Canada after it was alleged he had been selling misbranded and counterfeit prescription drugs. The story is somewhat more complicated than that.

Prior to the passage of the Medicare Part D prescription drug act, the purchase of name brand prescription drugs from Canada was becoming a significant business. Canada has price controls on prescription drugs and a name brand medication can be purchased in Canada for a significant discount over those purchased in the United States. Seniors and uninsureds looking for cheaper drugs found access to Canadian drugs either through storefront brokers in the United States or over the internet. However, since Canadian pharmacies could not accept US physician prescriptions directly, Canadian internet pharmacies came up with a system whereby a US citizen would fax their prescription to the pharmacy, a Canadian physician working with the pharmacy would write a prescription for the same drug and the Canadian pharmacy would fill it.

One of the originators of the internet Canadian pharmacy business was Andrew Strempler, who created Mediplan Pharmacy in Canada to service US customers and Mediplan did very well for a while. However, the FDA alleged that since the drugs did not come through the US system, the purchases were unlawful and moved with varying success against the US based companies involved in the business but were unable to move against the Canadian pharmacies that were following Canadian law.

google.jpgGoogle has for many years profited somewhat well from advertising by websites dedicated to gambling and internet pharmacy. Website owners who want to advertise on Google and other search engine companies bid on words in an ongoing auction. So, when a person enters a search term and advertisements pop up on the screen top and sides, it costs those advertisers money for the placement and for the number of clicks on those advertisements. Some of the highest cost adwords are for gambling and prescription drugs. Google has long had a strange relationship in that regard with their most profitable advertisers, at times being accused of enabling illegal conduct.
Google has taken steps over time to try to distance itself from some of those advertisers. Two years ago the United States passed the Ryan Haight Act to attempt to eliminate so called rogue internet pharmacies that provided prescription drugs without physician face to face interaction. Google had sought to limit the number of such pharmacies advertising on its search engine but there are still many that operate and advertise. In what seems to have been a long time coming, Google has now instituted a policy that requires any pharmacy related websites in the United Sates to be certified by the National Association of Boards of Pharmacies through its VIPPS program and for Canadian pharmacy websites to be certified by the Canadian International Pharmacy Association (CIPA.). The policy also prevents Canadian pharmacies from advertising in the United States.
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SAN DIEGO (January 26) Less than a year after a South Florida internet Pharmacy trial was dismissed in part due to prosecutorial misconduct, (click: here to read more) another large internet pharmacy case may be heading the same way. A federal judge in San Diego is considering dismissal of a case that initially ended in a mistrial last year after allegations arose that the prosecutor in the case made misstatements to the court about data on computer servers obtained by the government that defense attorneys had requested and were told didn’t exist. We reported about this case last summer here.

The Affpower case was the first internet pharmacy case to use the racketeering statute to prosecute a number of participants in an alleged unlawful internet pharmacy operation and for one of the first times included website owners who were marketers and not involved in the pharmacy or medical affairs of the operation. Defense attorneys had requested access to the computer servers holding the original data, a copy of some of which was used at trial. The prosecutor in the case reported to the Defendants and reportedly the court that the original data had been wiped clean off of the servers, the only data available was that which the government would be using at trial.

The mistrial occurred after the jury originally announced guilty verdicts for all defendants; the jury was polled and it was discovered that one juror did not agree with the verdict. In preparing for the retrial, defense attorneys asked to have an expert review the servers; the expert found that all of the original data was still on the servers. In a bluntly worded order, Chief Judge Irma Gonzalez has ordered prosecutors to explain why she should not dismiss the case due to the misconduct.

pc-doctor.jpgThe FDA recently moved to shut down internet pharmacy “affiliate” websites in the United States . The Ryan Haight Act, passed in 2008 was the first effort to define the lawful and unlawful practice of telemedicine with respect to controlled substances and required all internet pharmacies to register with the DEA. In addition, many states have moved to restrict or prosecute physicians and pharmacies involved in the internet sales of non-controlled substances. As a consequence, there are fewer of such operations inside the United States and often prescription drugs being purchased online are done from pharmacies located outside the United States . However, the marketers for such pharmacies are often website owners and advertisers known as “affiliates” located inside the United States. Recently the FDA targeted websites operating inside the United States as marketers.
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For more info about Buying Medicine and Medical Products over the Internet, click here.

By Robert David Malove, Esquire

Exclusive to the Health Care Fraud Blog

SAN DIEGO (July 15) In San Diego, on the 44th day of a trial highly touted “Affpower enterprise” internet pharmacy prosecution by the Justice Department, seven defendants learned they were convicted of a range of charges including racketeering. Ten minutes later, after the jury was polled, a juror stated she was coerced into her verdict. A mistrial was declared later, the government indicated it would be trying the defendants again and a briefing schedule was set for motions to dismiss indictment.

An Ohio pharmaceutical wholesaler, Masters Pharmaceutical, Inc, agreed to pay $500,000 and entered into a consent decree pertaining to compliance with DEA regulations in settlement of claims that the distributor unlawfully supplied controlled substances to unlawful internet pharmacies and failed to report those sales to the DEA.
The settlement agreement covers the sales of more than 4,199,465 dosage units of hydrocodone, phentermine and alprazolam that occurred between 2005 and 2008 and were not reported to the DEA. DEA has reporting requirements with respect to the theft or diversion of controlled substances under 21 C.F.R. 1301.74(b).
To read more, click here and here.

md.jpgOne significant development in the area of medical and pharmacy practice was the passage last year of The Ryan Haight Online Pharmacy Consumer Protection Act of 2008. This Act modifies the Controlled Substances Act to address the facilitation of the purchase or dispensing or controlled substances via the internet.

Under current DEA regulations, dispensing includes the not just the sale or provision of a prescription drug, but also the issuance of a prescription. The Act also seeks to define components of telemedicine involving controlled substances. The Act takes effect today. On April 6, 2009, the DEA issued interim rules on the implementation of the Act while regulations are formalized. The interim rules require any on-line pharmacy or physician practicing telemedicine to register with the DEA. However, some definitions and the commentary pertaining to the scope of the Act include some interesting positions as to the potential scope of the Act.

keyboard.jpgAmong the changes to the current Controlled Substances Act is a requirement of a face to face physician encounter prior to the issuance of a prescription for a controlled substances and a definition of a “covering physician” and “in person medical evaluation.” The regulatory definition of a “valid prescription” now is part of the statute and includes, in addition to the previous requirement that a prescription be “for a legitimate medical purpose in the usual course of a physician’s practice” to include that the practitioner must have conducted a least one in-person medical evaluation of the patient or be a covering physician.

By Robert David Malove, Esquire

Exclusive to the Health Care Fraud Blog

law%20def.jpgFORT LAUDERDALE, FL (April 6, 2008) In a stunning development with implications in two large prosecutions, the United States dismissed with prejudice an Indictment against 10 individuals today in a South Florida courtroom, two of whom had already plead guilty and testified in the trial against the other eight defendants. This follows an eight week trial featuring two mistrials, one based on prosecutorial misconduct and also included accusations against the government of witness tampering and the testimony of a federal prosecutor to attempt to refute the testimony that the government gave permission for one of the defendants to operate his business.

755991_pills.jpgExclusive COVERAGE BY Health CareFraud Blog

DALLAS, TX (August 27, 2008) – The federal government’s largest health fraud case involving online pharmacies was scheduled to conclude today with the sentencing of Ryokesh Johar Saran (Joe Saran) before US District Judge Jorge A. Solis in the Northern District of Texas. Saran as well and the 30 corporations he controlled were scheduled for sentencing. Sentencing for the corporate and individual defendants was indefinitely postponed due to the apparent heart attack Saran suffered en route to court.

Benson Weintraub, the nationally renown federal sentencing expert and a former full-time professor of law along with publisher of the Health Care Fraud Blog, Robert Malove, both of Fort Lauderdale have represented Saran and the corporate defendants for more than two-years and have been mounting a virtually unprecedented course of complex presentece litigation. The defense has challenged the criminalization of Group Purchasing Organizations (GPO), comparing it to “pharmaceutical arbitrage” according to recent defense pleadings.

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