What Happened
A Clinton Township, Michigan physician and the owner of a pharmacy sharing his office complex agreed to pay a combined $700,948.42 to resolve allegations that the physician prescribed unnecessary controlled substances that the pharmacy then filled.
Dr. Stephen Swetech operated a medical practice in an office complex that also housed a physical therapy center and a pharmacy, Heartland Drugs, owned by Yasser Maisari. The government alleged that from 2016 through 2018, Dr. Swetech prescribed medically unnecessary opioid and attention-deficit/hyperactivity disorder medications, and that Heartland Drugs filled those prescriptions, generating claims submitted to federal health care programs in violation of the False Claims Act.
The settlement also resolved a separate allegation that, from 2018 through 2020, a nearby laboratory indirectly paid Dr. Swetech above-market rent for office space as an inducement for his patient referrals — a self-referral arrangement barred under federal anti-kickback law. As part of the resolution, Dr. Swetech agreed to rescind his DEA registration and never again prescribe, administer, or dispense controlled substances.
What Went Wrong
- A co-located pharmacy filled prescriptions from a co-located prescriber without independent scrutiny. The physical and business proximity between the practice and the pharmacy appears to have reduced the pharmacy's independent check on prescription validity.
- Medical necessity wasn't documented or reviewed. Opioid and stimulant prescriptions were issued and filled at volume without an apparent independent medical-necessity review process.
- Financial relationships between the practice, a lab, and the pharmacy were not screened. Overlapping business interests among the office-complex tenants created inducement risks that went unchecked for years.
How It Could Have Been Prevented
- Require pharmacies to apply the same corresponding-responsibility scrutiny to co-located or affiliated prescribers as they would to any outside prescriber.
- Document medical necessity for controlled-substance prescriptions, particularly opioid and stimulant combinations, and make that documentation available for pharmacy verification.
- Screen office-complex leases and referral relationships among co-located medical, laboratory, and pharmacy tenants for Anti-Kickback Statute and Stark Law compliance.
- Conduct periodic third-party audits of prescribing and dispensing volume when a prescriber and pharmacy share an office or ownership ties.
Related Guidance
- Regulatory Guide — Corresponding-responsibility obligations linking prescribers and pharmacies.
- 15 Red Flags of Drug Diversion — Indicators of prescribing and dispensing collusion.
- Community Pharmacy Self-Assessment Checklist — Self-assessment for pharmacy dispensing controls.
- More Diversion Case Studies — Other physician-pharmacy settlement cases.