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The Stakes Are High

Healthcare-Medicaid-4
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Mississippi residents Dempsey “Bryan” Levi, 51, and Jeffrey Wayne Rollins, 44, have been sentenced for their role in a multi-million-dollar scheme to defraud healthcare programs. This included defrauding Tricare, the healthcare benefit program that provides affordable insurance for members of the U.S. military, veterans, and their family members.

Rollins and Levi previously pled guilty to conspiracy to commit health care fraud by carrying out  a fraudulent billing scheme. The defendants admitted to operating The Gardens Pharmacy, LLC, which operated as an open-door retail pharmacy specializing in the production of compound medications. (Looks like their once open doors are now going to be closed indefinitely.)

The duo abused their positions to solicit recruiters to obtain prescriptions for compounded medications. The recruiters were illegally paid a percentage of the reimbursements that health care benefit programs paid to the pharmacy for Medicare and TRICARE beneficiary prescriptions. (It is obviously illegal to pay kickbacks for prescriptions, let alone pay kickbacks using money obtained from federal healthcare programs.)

Rollins and Levi also admitted to soliciting and incentivizing doctors to authorize prescriptions for the compounded medications. They assisted in filling out these prescriptions by formulating compound medications that were targeted to maximize reimbursements from health care programs. (This means they added expensive ingredients to the compound medications and charged thousands of dollars per prescription, whether it was needed or not.)

The ordered prescriptions were strictly the result of kickback referrals and not medically necessary, ordered without evaluation of a patient, and often scheduled to be automatically refilled without notifying the patient. (The victims did not know they had been exploited.)

Both Levi and Rollins were sentenced to serve 84 months in federal prison, followed by three years of supervised release. They were also ordered to pay $16,333,583 in restitution to Medicare, Tricare and Express Scripts. (Maybe that will teach them a lesson.) Additionally, the government received a forfeiture of $924,114.40.

Today’s Fraud of the Day comes from a Department of Justice press release, “Ocean Springs Men Sentenced to Federal Prison for Conspiring to Commit Health Care Fraud,” dated March  24, 2021.

Hattiesburg, Miss. – Dempsey “Bryan” Levi, 51, and Jeffrey Wayne Rollins, 44, of Ocean Springs, were sentenced today by U.S. District Judge Keith Starrett for their role in a multi-million dollar scheme to defraud TRICARE, the health care benefit program serving U.S. military, veterans, and their family members, as well as private health care benefit programs, announced Acting U.S. Attorney Darren J. LaMarca and Special Agent in Charge Michelle Sutphin of the Federal Bureau of Investigation in Mississippi.

Both Levi and Rollins were sentenced to serve 84 months in federal prison, followed by three years of supervised release, and pay $16,333,583 in restitution to Medicare, Tricare and Express Scripts. Additionally, the government received a forfeiture of $924,114.40.

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