Four Men, Seven Companies Behind Billion Dollar Telemedicine Fraud Scheme

Late last week, according to the Federal Bureau of Investigation (FBI), a District Court in Tennessee “unsealed a 32-count indictment charging four individuals and seven companies in a $1 billion health care fraud scheme.”

The companies named in the indictment are Precision Pharmacy Management, Tanith Enterprises, ULD Wholesale Group, and Alpha-Omega Pharmacy in Clearwater, Florida; Synergy Pharmacy Services in Palm Harbor, Florida; Germaine Pharmacy in Tampa; and Zoetic Pharmacy in Houston, Texas. The pharmacies were owned and used by the men as “compounding pharmacies” and the men were charged with “conspiracy to commit health care fraud, mail fraud, and introducing misbranded drugs into interstate commerce.”

According to the FBI, the men ran “an elaborate telemedicine scheme in which HealthRight (another company charged separately for its involvement) fraudulently solicited insurance coverage information and prescriptions from consumers across the country for prescription pain creams and other similar products.” Doctors then “approved the prescriptions without knowing that the defendants were massively marking up the prices of the invalidly prescribed drugs, which the defendants then billed to private insurance carriers.”

The defendants’ scheme involved “tens of thousands of patients and more than 100 doctors located in the Eastern District of Tennessee and across the country for the purpose of defrauding private health care benefit programs such as Blue Cross Blue Shield of Tennessee out of approximately $174,000,000.”

According to the indictment, “the defendants submitted not less than $931,000,000 in fraudulent claims for payment.”

If convicted, the defendants face “up to 20 years imprison for each mail fraud charge, 10 years in prison for conspiracy, and up to three years in prison for introducing misbranded drugs into interstate commerce.”