{"id":54727,"date":"2023-11-15T13:16:37","date_gmt":"2023-11-15T21:16:37","guid":{"rendered":"https:\/\/cjnotebook.com\/?p=54727"},"modified":"2023-11-15T13:16:37","modified_gmt":"2023-11-15T21:16:37","slug":"three-sentenced-tuesday-for-54-million-bribery-and-kickback-scheme-involving-health-insurance","status":"publish","type":"post","link":"https:\/\/cjnotebook.com\/?p=54727","title":{"rendered":"Three Sentenced Tuesday for $54 Million Bribery and Kickback Scheme Involving Health Insurance"},"content":{"rendered":"
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\"\"Three men were sentenced Tuesday to a $54 million bribery and kickback scheme involving TRICARE.<\/span><\/p>\n

This federal program provides health insurance benefits to active duty and retired service members and their families.\u00a0<\/span><\/p>\n

David Byron Copeland, 55, of Tallahassee, Florida, was sentenced to four years and three months in prison following his conviction at trial in June for paying and receiving health care kickbacks.\u00a0 \u00a0<\/span><\/p>\n

James Wesley Moss, 60, of Huntsville, Alabama, and Michael Gordon, 60, of Fort Myers, Florida, were sentenced to two years and three months and one year and six months in prison, respectively, following their guilty pleas to a kickback and fraud conspiracy, among other charges.<\/span><\/p>\n

According to court documents and evidence presented at trial, Moss was a part-owner and CEO of Florida Pharmacy Solutions (FPS), a Florida-based pharmacy specializing in compounded prescription drugs. <\/span><\/p>\n

\"\"Copeland was also a part-owner and senior sales manager at FPS, and Gordon was a lead sales representative. <\/span><\/p>\n

Moss, Copeland, and Gordon, along with their accomplices, engaged in a practice known as \u201ctest billing\u201d to develop the most expensive combination of compounded drugs to maximize reimbursement from TRICARE. <\/span><\/p>\n

Moss, Copeland, Gordon, and their accomplices targeted physicians who treated TRICARE beneficiaries and paid bribes and kickbacks to physicians and salespeople to encourage the referral of prescriptions to FPS. The bribes included lavish hunting trips and expensive dinners. <\/span><\/p>\n

\"FBI
FBI Photo Image<\/figcaption><\/figure>\n

In addition, FPS employees used \u201cblanket letters of authorization\u201d that allowed FPS to modify the prescription components to make them more profitable.\u00a0 \u00a0<\/span><\/p>\n

Moss paid Copeland and Gordon millions of dollars in kickbacks based on a percentage of the amount that TRICARE reimbursed for their prescriptions, which provided an incentive to seek prescriptions for the most expensive compounded drugs possible, including pain and scar creams. <\/span><\/p>\n

Copeland facilitated the kickbacks through companies he set up to receive and funnel the payments. From late 2012 through mid-2015, FPS billed TRICARE over $54 million for its compounded pharmaceuticals.\u00a0 \u00a0<\/span><\/p>\n

In April, co-defendant Edward Christopher White was sentenced to two years and nine months in prison after pleading guilty for his role in the scheme.<\/span><\/p>\n<\/div>\n

\"\"The Department of Defense Office of Inspector General, the Department of Health and Human Services Office of the Inspector General,\u00a0and the FBI investigated this case.<\/span><\/p>\n

\n

Trial attorneys Devon Helfmeyer, Clayton Solomon, and Katie Rookard of the Criminal Division\u2019s Fraud Section prosecuted the case.<\/span><\/p>\n

The Fraud Section leads the Criminal Division\u2019s efforts to combat healthcare fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of nine strike forces operating in 27 federal districts, has charged more than 5,000 defendants, who have billed federal healthcare programs and private insurers more than $24.7 billion. <\/span><\/p>\n

In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Health and Human Services, are taking steps to hold providers accountable for their involvement in healthcare fraud schemes. <\/span><\/p>\n

More information can be found at www.justice.gov\/criminal-fraud\/health-care-fraud-unit<\/a>.<\/span><\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Three men were sentenced Tuesday to a $54 million bribery and kickback scheme involving TRICARE. This federal program provides health insurance benefits to active duty and retired service members and their families.\u00a0…<\/p>\n","protected":false},"author":1,"featured_media":54728,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-54727","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-u-s-department-of-justice"],"yoast_head":"\nThree Sentenced Tuesday for $54 Million Bribery and Kickback Scheme Involving Health Insurance<\/title>\n<meta name=\"description\" content=\"Three men were sentenced Tuesday to a $54 million bribery and kickback scheme involving TRICARE. 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