Pharmacist and Pharmacy Employee Sentenced for Involvement in Over $30 Million Health Care Fraud

[nitpicker]

https://www.justice.gov/usao-sdfl/pr/pharmacist-and-pharmacy-employee-sentenced-involvement-over-30-million-health-care

Department of Justice
U.S. Attorney’s Office
Southern District of Florida

FOR IMMEDIATE RELEASE
Monday, March 12, 2018

Pharmacist and Pharmacy Employee Sentenced for Involvement in Over $30 Million Health Care Fraud

A pharmacist and his employee were sentenced on Friday for their involvement in a $30 million health care fraud scheme against Tricare, the health care program for military service members, veterans and their families. This case was largest health care fraud case involving the Tricare program to go to trial.
(snip)

On March 9, 2018, Serge Francois, 52, of Southwest Ranches, Florida was sentenced to 204 months in prison to be followed by three years supervised release by U.S. District Judge Darren P. Gayles. Francois was ordered to pay $31,259,252 in restitution. Patrick Tonge, 42, of Southwest Ranches was sentenced to 188 months in prison, to be followed by three years of supervised release. Tonge was also ordered to pay $31,259,252 in restitution.

On September 5, 2017, after a one-month trial, a federal jury found Francois guilty of conspiracy to commit health care fraud in violation of Title 18, United States Code , Section, 1349 twelve counts of health care fraud in violation of Title 18, United States Code, Section 1347, conspiracy to pay kickbacks in connection with a federal health care program in violation of Title 18, United States Code, Section 371, five counts of paying kickbacks, in violation of Title 42, United States Code, Section 1320, and twelve counts of money laundering, in violation of Title 18, United States Code, Section 1957. In addition, Francois was found guilty of eight counts of introducing misbranded drugs into interstate commerce in violation of Title 21, United Sates Code, Section 331, four counts of making false statements related to health care matters, in violation of Title 18, United States Code, Section 1035 and one count of making a false statement on a DEA form, in violation of Title 21, United States Code, Section 843. The jury found Patrick Tonge guilty of the same conspiracy charges, eleven counts of health care fraud, three counts of paying kickbacks, and two counts of money laundering. The scheme caused over $31 million in loss to the federal Tricare program and the Federal Employee Health Benefit Program (“FEHBP”), with over $30 million in loss to Tricare alone. The trial was a culmination of a three-year investigation that resulted in 18 convictions.

According to evidence presented at trial, Francois, a pharmacist, owned and operated Atlantic Pharmacy and Compounding, located in Pompano Beach, Florida. From there, Francois and his assistant at the pharmacy, Tonge, entered into a vast conspiracy with so-called marketers who paid physicians to write prescriptions for expensive topical medications that cost up to $17,000 a bottle. As the pharmacist-in-charge, Francois was responsible for the compounded medications, which were made in house by the pharmacy.

Francois, Tonge and their co-conspirators agreed to automatically refill the prescriptions, sending numerous refills to patients who did not request them and not charging a co-pay. Francois and Tonge would also pay the marketers from the profits received for each prescription and the marketers, in turn, would pay the physicians. Evidence further showed that some physicians never saw the purported patients. Rather, they used the patient’s identification to write the prescriptions.

The trial evidence revealed that Francois and Tonge specifically targeted the Tricare program. Throughout the conspiracy, Atlantic Pharmacy submitted thousands of claims which led Tricare and FEHBP to make payment to Atlantic Pharmacy and Compounding in the approximate amount of $31,259,252. Further evidence presented at trial showed that Francois used the fraud proceeds to buy a $3.6 million mansion once owned by Dwayne “the Rock” Johnson, as well as a Ferrari, two Rolls Royce Motor vehicles, and over $1 million in other luxury automobiles.
(snip)

[safeinOhio]

1. sentenced to 204 months in prison to be followed by three years supervised release by U.S. District

About time White Collar crime gets a real sentence and fine.

[HopeAgain]

2. $17000 per bottle

I guarantee there weren't more than $150 worth of compounded non-sterile ingredients in that bottle. Not excusing the grifters, but that kind a administrative mismanagement only invites fraud.

[Sherman A1]

3. I hope that every dime

Is recovered and these folks spend some quality time as guests of the penal system.