McAllen pharmacist pleads guilty in $7.5M kickback scheme

Woman faces 5 years in prison in connection with crime

McALLEN — A pharmacist here entered a guilty plea for her role in an alleged healthcare fraud scheme that netted her more than $7 million in kickbacks, according to an indictment.

Standing before U.S. District Judge Micaela Alvarez, Victoria Renee Guerra, 35, of McAllen pleaded guilty Thursday to a sole count of conspiracy to violate the federal anti-kickback statute, which prohibits paying kickbacks to get physicians to write prescriptions.

READ SUPERSEDING INDICTMENT

Having made the plea a month after pleading not guilty before a U.S. magistrate judge, Guerra worked as a marketer during the nearly two-year scheme, which according to court records began in August 2014 and continued to about June 2016.

The elements involved include the Federal Employees Compensation Act, or FECA, a healthcare benefit, and the Department of Labor-Office of Workers Compensation Program, or DOL-OWCP, records show.

The indictment further read that the “kickbacks and bribes” were to “induce said physicians to refer individuals for the furnishing and arranging for the furnishing of any item and service, for which payment may be made in whole or in part by FECA.”

Government prosecutors alleged that the object of the conspiracy was for Guerra and others to unlawfully enrich themselves through the scheme, specifically to bribe one or more physicians to send prescriptions for FECA beneficiaries, including compound prescriptions to an unnamed pharmacy in the Rio Grande Valley referred to as “Pharmacy A” in the indictment.

A compound drug, “in general, ‘compounding,’ is the practice in which a licensed pharmacist, a licensed physician, or in the case of an outsourcing facility, a person under the supervision of a licensed pharmacist, combines, mixes, or alters ingredients of a drug or multiple drugs to create a drug tailored to the needs of an individual patient,” the filed indictment states.

Guerra’s role was as a “purported marketer” for Pharmacy A.

“Among other things, Pharmacy A filled prescriptions for compound drugs for which claims were submitted to healthcare benefit programs, including DOL-OWCP,” the record shows.

Guerra and her co-conspirators did this by marketing compound creams and other medications to doctors treating DOL-OWCP patients and induced doctors to send prescriptions for compound medications to Pharmacy A.

In addition, Guerra recruited a physician, referred to in the indictment as “Doctor 1,” to write prescriptions for compound creams and other medications for DOL-OWCP patients to be filled by Pharmacy A.

“Guerra provided Doctor 1 with prescription pads that were designed to maximize reimbursement from DOL-OWCP,” the court record shows. “Doctor 1 sent, and caused to be sent, prescriptions to Pharmacy A for compound creams and other medications for DOL-OWCP patients in return for kickback payments from Guerra totaling approximately $2.1 million.”

The owner of Pharmacy A paid Guerra approximately $7.5 million in return for prescriptions sent by Doctor 1, and other doctors, to his pharmacy, the indictment states.

Guerra allegedly used those payments, in part, to pay kickbacks to Doctor 1 in return for the prescriptions sent by Doctor 1 to Pharmacy A.

“During the conspiracy, various entities were used to make kickback payments to Doctor 1,” the documents state. “Pharmacy Owner used a limited liability company to make payments to a limited liability company established by Guerra. Guerra in turn, used her (LLC) to make payments to an (LLC) used by Doctor 1.”

During the course of the nearly two years, Pharmacy A submitted claims to DOL-OWCP for prescriptions written by Doctor 1 totaling $42.2 million, of which DOL-OWCP paid about $18.2 million to Pharmacy A, the record shows.

In furtherance of the conspiracy, and to accomplish its object and purpose, Guerra made, or caused to be made, several payments totaling approximately $2.1 million to Doctor 1 through limited liability company used by Doctor 1.

According to a superseding indictment filed March 7, Guerra made one such payment on October 2014 in the amount of $216,018.63, and another one less than a month later on Oct. 29, 2014, in the amount of $268,153.05.

Guerra, who will remain free on a $50,000 bond, is scheduled to be sentenced on May 29.

She faces up to five years in federal prison and up to $25,000 in fines.