Reversal of Fortune

36414458 - rear view of a pharmacist working in lab coats in the pharmacy

What do a Hollywood star’s former home, luxury cars and a lavish lifestyle have in common? They are some of the assets belonging to today’s fraudster, a South Florida pharmacist, who spearheaded a healthcare fraud scheme that stole $31 million from TRICARE.

TRICARE is the nation’s military healthcare program, which serves nine million members and veterans. Today’s fraudster, who owned a Pompano Beach-based pharmacy, and co-conspirators billed the government healthcare program for $37 million in fraudulent claims for compounded pain medications that were not medically necessary, nor properly prescribed.

The wealthy pharmacist, who was called “POTUS” (President of the United States) by fellow co-workers at the pharmacy, did not carry the scheme out alone. His “Chief of Staff,” a former car salesman who managed his pharmacy, assisted by processing the fraudulent TRICARE claims. (How would a former car salesman be qualified to manage a pharmacy? Looks like he sold the government 31 million lemons.) The pharmacist purportedly paid kickbacks to doctors to receive patient referrals. (Then he signed off on unnecessary prescriptions for the compounded medications.)

During a trial by jury, the pharmacist testified that he was not aware of any kickback payments. His attorney tried to blame the scam on co-workers who were not only tricking the pharmacist by paying kickbacks for new patients, but also the government by filing fraudulent claims.

The evidence against the pharmacist was significant, especially the government witnesses who testified that almost every day, unwanted medications were returned to the pharmacy by customers who stated they didn’t order the medications or didn’t want the refills they had received. (The returned medications were relabeled, then shipped to other customers and billed to TRICARE again.) There were also mounds of paperwork and lists of unnecessary prescription-drug orders initialed by the pharmacist and presented as evidence against him.

The scheme, which occurred over five years, netted the pharmacist $31 million. He used that illegally-gained money to purchase the 10,000 sq. ft. Broward County French-style chateau that was formerly owned by Hollywood star, Dwayne “The Rock” Johnson. He not only lived in style, but also drove in a fleet of luxurious vehicles after purchasing a Rolls-Royce, Ferrari, Land Rover, Lamborghini, Cadillac Escalade and a Mercedes-Benz.

It took the Miami federal jury 12 hours of deliberation to return a guilty verdict for the 51-year-old former pharmacist and his 40-year-old pharmacy manager. In addition to being guilty of healthcare fraud, the pharmacist was also found guilty of money laundering. (And, let’s not forget to mention that he neglected to pay $60,000 in property taxes.)

The pharmacist, who had been licensed for 20 years, had beat a former federal prosecution almost a decade ago. (This time, he wasn’t so lucky.) Both the pharmacist and his pharmacy manager are facing 10 to 20 years in prison. They are scheduled for sentencing in November.

Because he was deemed a flight risk, the pharmacist is currently being held in a tiny jail cell in downtown Miami. This reversal of fortune is a far cry from his former six bedroom, six bathroom estate on two acres in Broward County. Congratulations to the investigators who brought this man down and added him to the list of four other South Florida doctors who have pleaded guilty in the case.

Today’s “Fraud of the Day” is based on an article entitled, South Florida pharmacist bought The Rock’s mansion. Now he’s convicted of fleecing healthcare programpublished by The Miami Herald on September 6, 2017.

Some nine million members and veterans of the nation’s military services receive medical coverage from a U.S. government program called TRICARE.

It’s a system built on trust — making it an easy mark for seasoned South Florida pharmacist Serge Francois, prosecutors say. Francois, 51, stood trial over the past month on charges of fleecing tens of millions from the taxpayer-funded military program to buy the former Broward County mansion of Hollywood megastar Dwayne “The Rock” Johnson.

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Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.