A trio of individuals are facing Federal felony charges on allegations by investigators that they were involved in schemes to defraud Medicare, TRICARE, and private insurance companies and launder the proceeds of the fraudulent activity.
Per investigators, beginning in early 2011 the three men began several efforts at defrauding Medicare and TRICARE by allegedly fraudulently formulating and shipping compounded medicines, then billing insurance providers for the same. Private insurers were allegedly victimized by the trio, accounting for over $13 million of the fraud charged against them. The men allegedly used the rubric of several compounding entities to accomplish the fraud.
In an effort at furthering the scheme, prosecutors say the men sought and paid illegal kickbacks and bribes to marketers, physicians, and several others for referrals of prescriptions to their various pharmacies. The defendants allegedly tried to mask the ill-gotten proceeds by laundering it through several monetary purchases in excess of $10,000 each, including the purchase of real estate, luxury cars, diamonds, and other such items.
The bulk of the charges against the three men revolve around billing of Medicare, TRICARE, and private insurance for medically unnecessary compounded medications.