Different healthcare providers have previously participated in schemes to defraud healthcare programs set aside to assist the American civil servants and their dependents. This is a fact that is proven from the numerous cases presented and heard in the court of law. It is therefore well established that this is a burning issue in modern-day society. In addition to that, it is well established that most law enforcement agencies in the United States have focused their efforts on bringing justice to such cases. One of the common cases that received enormous attention among the United States law enforcement agencies is the one that involved three defendants who allegedly defrauded the military program called TRICARE. This scheme allegedly defrauded this program of $65 million.
This case involved Jeremy Syto, Daniel Castro, and Kyle Adams as the defendants presented in court. Additionally, their ring leaders (Jimmy and Ashley Collins) were also charged on the court of law. According to the case presented in the court, it is evident that Syto, Castro, and Adams were involved in a healthcare fraud scheme that paid them in terms of millions. This case involved the recruitment of TRICARE beneficiaries to the scheme. These beneficiaries claimed that they were prescribed expensive compounded medication several times. According to the evidence presented in the court, the medication that was allegedly prescribed for these patients summed to $14,500 per medication in a month. However, it is well established that the claims that the patients under the TRICARE did not receive any medication at all.
This case involved numerous details that were looked into in the court. These details made the counts of the case in the court of law. Syto, Castro, and Adams admitted in the court of law that they were guilty of the alleged healthcare fraud that defrauded TRICARE healthcare program millions of dollars. They recruited patients who were beneficiaries of the TRICARE for Jimmy and Ashley Collins. The recruited patients agreed to act as a part of an ongoing medical study. These patients accepted for some payment and they then lied that they participated in the medical study. In reality, there was no medical study that was conducted. These recruiters, that are Syto, Castro, and Adams convinced some TRICARE beneficiaries to register to participate in the scheme. After this, the beneficiaries were sent to the medical center and pharmacies owned by Jimmy and Ashley Collins called Choice MD.
The employees of Choice MD included Dr. Carl Lindblad, Dr. Susan Vergot, and Candace Craven was then advised to write prescriptions for these TRICARE beneficiaries. There were no tests conducted or any medical diagnosis and also they were not involved in any engagement in person. After signing these prescriptions, the medicine products were not given to the patient but were rather sent to a pharmacy called The Medicine Shoppe. This pharmacy filled the billing information for the prescription to TRICARE and in turn, received a massive payment for the medication. The establishment of this case was based on the reimbursing of the medication from Choice MD. Unfortunately, after TRICARE stopped reimbursing these forms of medication, Choice MD authorized 4,442 prescriptions. Additionally, the company billed TRICARE a sum of $65,679,512.00 for these prescriptions.
The alleged culprits, in this case, included Jeremy Syto, Daniel Castro, and Kyle Adams. This scheme also involved some kickback payments by the owner of the Medicine Shoppe to the Collinses. According to the court proceedings, by February 2015, the kickback payment paid to the Collinses had summed to a total of 45.7 million dollars. This was considered as part of the lost sum by the TRICARE program. From all these, it is well established that the federal government had lost a huge amount of money to this scheme. On the other hand, such schemes have been common in modern-day society. Several culprits have been presented in court and therefore the law enforcement agencies have come forth with their reliable and efficient strategies to capture the alleged criminals and bring them to justice. Also, the sentences in court were harsh.
First and foremost, the alleged criminals were charged with three counts of criminal attempts to commit healthcare fraud. In this case, different agencies including Defense Criminal Investigative Service, IRS Criminal Investigation Division, Gulfport, MS, Naval Criminal Investigative Service, and an officer from the Federal Bureau of Investigation – Jackson, MS Field Office. This brings forth the involvement of several law enforcement agencies in this case. Therefore it is well established that such cases receive enormous attention. Furthermore, Charge Amy Murphy outlined the dire need of all the military personnel to come forth and safeguard the military healthcare programs from possible fraudulent activities by different partners.
On the other hand, the case counts included conspiracy to commit healthcare fraud as the first count, conspiracy to receive or pay illegal remuneration and conspiracy to defraud the federal program formed the second count and then a receipt for illegal remuneration formed this case’s ten counts, that is from 3 – 13. Additionally, this case had different court maximum sentences. Count 1 had a maximum sentence of a fine of twice the lost amount to the scheme or amount of $250,000 and ten-year imprisonment. Count 2 on the other hand had a maximum court sentence of $250,000 fine or twice the lost amount or five-year imprisonment. Counts 3 to 13 also had a fine of $250,000 or twice the amount lost per count. Additionally, these counts had a potential sentence of five years in prison. Therefore, it is well established that these are harsh sentences that every victim of such situations would want to evade.
This case attracted this form of penalties as well as the grave attention among the law enforcement agencies as it involved defrauding the healthcare program meant to assist the medical needs of the military body. The importance of the military body to a nation is well documented. Robert Brewer, a US Attorney General outlined that the Military is an important body in San Diego and therefore defrauding this body would not be taken lightly. Charge Amy Murphy, under the NCIS Marine Corps, outlined that the law enforcement agencies will continue to conduct an extensive investigation on such cases and all the alleged culprits will be brought to justice. It is therefore well established that this is a case that attracted much attention and also extensive investigative work.
It is therefore well established that law enforcement agencies have come forth to ensure that the culprits of healthcare fraud are brought to justice. Additionally, the fact that the culprits stand a chance of harsh lawsuits is also portrayed by the case presented above. Alleged culprits, therefore, have to seek assistance. In case you find yourself in such cases, be aware that you stand a chance of facing enormous charges and destructive lawsuits. Therefore, be swift to seek legal and any other forms of assistance to remedy or control the possible damage. The Healthcare Fraud Group stands to assist any healthcare providers and companies that fall victim to such a situation. Our main aim is to ensure that you are effectively represented in the court of law. Contact us at 888-402-4054 for free consultations.