Fraud from A to Z

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The president and owner of the A to Z Pharmacy in New Port Richey, Florida used his business as a cover for a massive compounding pharmacy fraud scheme that stole more than $100 million from private insurance companies, Medicare and TRICARE. The healthcare fraud scheme which ran for just over three years, involved seven other individuals who have all previously pleaded guilty to their roles. (I guess they saved the worst – the mastermind – for last.)

 The pharmacy owner concocted his multimillion dollar scam using drug compounding, then fraudulently billed a variety of insurance programs. Pharmacists or physicians compound various drugs to create medication to help a patient with a specific problem. (In this case, the pharmacist oversaw the production of pain and scar creams.)

The pharmacist used the six pharmacies he owned and operated plus various shell companies that he and his co-conspirators propped up to hide the $100 million scam. (In addition to A to Z Pharmacy, the pharmacist also used three pharmacies in Miami and another two in Hialeah.) These companies were used to submit false and fraudulent reimbursement claims for prescription compounded medications. The mastermind admitted that he and his co-conspirators manipulated the billing codes in the reimbursement claims and submitted claims for pharmaceutical ingredients they did not have.

The ruse included a physician who signed prescriptions for patients he never saw. The pharmacist and his co-conspirators regularly paid kickbacks and bribes to increase the amount of prescriptions they processed. (They also paid for patients’ personal information to increase participation in their illegal plan.) The owner of the A to Z Pharmacy paid out proceeds from his fraudulent operation to co-conspirators by wire transfer, purchase of assets, or via checks. (Some of the assets purchased included property, antique cars and a cigarette racing boat. In total, assets seized were valued at $7.6 million.)

The 45-year-old pharmacy owner pleaded guilty to one count of conspiracy to commit healthcare fraud and one count of conspiracy to engage in monetary transactions involving criminally derived property. He is facing 15 years in prison when sentenced.

The criminal’s seven co-conspirators that previously pleaded guilty to healthcare fraud are between the ages of 48 and 71 and hailed from Boca Raton, Fort Lauderdale, New Port Richey and Parkland. (Sounds like this Florida fraud club will no longer be enjoying their 1964 Corvette, 1967 Camaro, 1970 Monte Carlo, 2008 Lamborghini convertible, multiple luxury properties or racing boat.)

Today’s fraudster was well-versed in the ABC’s of fraud, so typical of those who carryout similar schemes. The New Port Richey, Florida fraudster AVOIDED his responsibility to carry out his duties as a pharmacist with BRAZEN lies and COLLUSION amongst co-conspirators. Thankfully, the Medicare Strike Force has brought this crime spree to an end. My guess is that the Justice Department will ZEALOUSLY ZAP this criminal and his co-conspirators with a sentence they will not soon forget.

Today’s “Fraud of the Day” is based on a Department of Justice press release entitled, “Owner of Florida Pharmacy Pleads Guilty in $100 Million Compounding Pharmacy Fraud Scheme; Real Properties, Cars and a 50-Foot Boat Will Be Forfeited,” released on November 6, 2017.

The president and owner of a Florida pharmacy that was at the center of a massive compounding pharmacy fraud scheme, which impacted private insurance companies, Medicare and TRICARE, pleaded guilty today for his role in the scheme.  Seven other individuals have previously pleaded guilty in connection to the scheme.  Various real properties, cars and a 50-foot boat will be forfeited as part of the guilty pleas.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney W. Stephen Muldrow of the Middle District of Florida, Special Agent in Charge Eric W. Sporre of the FBI’s Tampa Field Office, Special Agent in Charge Robert F. Lasky of the FBI’s Miami Field Office, Special Agent in Charge Shimon Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office and Resident Agent in Charge Brooke Harris of the U.S. Defense Criminal Investigative Service’s (DCIS) Tampa Regional Office made the announcement.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.