Florida Compounding Pharmacy Owner Indicted in TRICARE Fraud Case

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Florida Compounding Pharmacy Owner Indicted in TRICARE Fraud Case

A federal jury in Pensacola, Florida, has found Andrew E. Fisher guilty of conspiracy to commit healthcare fraud, conspiracy to commit wire fraud, and conspiracy to commit money laundering. The jury found that Fisher, who owns Physician Specialty Pharmacy, orchestrated an elaborate scheme to recruit TRICARE beneficiaries to overbill the program for compounded medications.

Fisher enlisted a sales representative named Michael Scott Burton to find TRICARE beneficiaries willing to receive prescriptions filled by Physician Specialty Pharmacy. Doctors prescribed the pricey medications to patients they had never seen, and Fisher directed pharmacy staff to use ingredients that would maximize billings. It was not uncommon for a single prescription to have a price tag above $12,000.  

The U.S. Attorney for the Northern District of Florida, Lawrence Keefe, said in a statement that Fisher and his co-conspirators "stole from taxpayers at the expense of the health and well-being of heroes who willingly served our nation or supported loved ones as they did so." For Special Agent in Charge of the Defense Criminal Investigative Service Cynthia A. Bruce, the defendant “conspired to deprive the DoD of precious resources needed for the healthcare of DoD Families."

Andrew E. Fisher was not the only individual convicted in the case. Burton and four other defendants had previously pleaded guilty. Burton was sentenced to 96 months in prison, while Fisher will hear his sentence in May 2020. 

The Cost of TRICARE Fraud  

In 2015, compounded medications cost TRICARE $1.5 billion over six months. This excessive expense prompted an investigation, which revealed that over 120 individuals had conspired with compounding pharmacies to defraud the government out of $65 million.  

The defendants in the case included several service members. One of them was Army Staff Sgt. Cordera Hill, who marketed compound medications to military personnel and their dependents. Hill recruited TRICARE beneficiaries who were willing to accept medications prepared by LifeCare Pharmacy.  

Cordera Hill was part of a wide-ranging network of patient recruiters that included Anthonio Miller, a Navy petty officer, and Rashad Barr, an IT specialist in the Army Reserve. Hill, Miller, and Barr paid the beneficiaries they recruited between $50 and $100 for ordering compounded ointments. Hill’s dealings with 21 patients directly caused Lifecare to receive $813,600 in TRICARE reimbursements. Hill was eventually sentenced to two years in prison.

The same patterns were repeated throughout Florida, California, Tennessee, and beyond. Compounded medications received by patients recruited by a single defendant in the case, Marine Bradley White, cost TRICARE $7.6 million. For his role in the scheme, White received $200,000. 

Investigations into compounding pharmacy fraud against TRICARE have resulted in recoveries surpassing $280 million. The Department of Defense’s healthcare program is now reviewing compounding pharmacies billings more carefully, and new rules have been implemented to prevent fraud. However, it is very likely that dishonest providers are still billing the government for unnecessary and overpriced compounded medications.

Whistleblowers with information about compounded medication fraud against TRICARE must come forward to help stop fraudsters and recover taxpayer funds. For their efforts, tipsters can be rewarded with up to 30 percent of any resulting recoveries. If you suspect a pharmacy, doctor, or patient recruiter is involved in a fraudulent scheme, contact a whistleblower attorney today.  

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David Kani

David Kani is a Southern California based trial lawyer with a focus on class actions and whistleblower (False Claims Act, SEC and others) cases.

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