Tuscaloosa, Alabama – Between 26th and 29th April 2021, L. Scott Coogler, Chief U.S. District Judge, sentenced two dozen accused persons who were part of a major scheme to perpetrate health care fraud, reported Prim F. Escalona, U.S. Attorney, FBI Special Agent-in-Charge Johnnie Sharp, Jr., Special Agent in Derrick L. Jackson Charge of the Health & Human Services Department – Office of Inspector General, Special Agent Cynthia Bruce in Charge of the Defense Criminal Investigative Service, Houston Division U.S. Postal Inspector in Charge Adrian Gonzalez, and Special Agent James E. Dorsey in Charge of the Internal Revenue Service – Criminal Investigation.
The accused persons sentenced comprised an array of firms managers and executives, billers, a prescriber, and salespersons. Among those convicted between 26th and 29th April 2021 were:
John Jeremy Adams, age 40, from Panama City Beach, Florida, the CEO & President of Global Compounding Pharmacy, who led the schemes and amassed millions of U.S. dollars from it, was convicted to an imprisonment term of 14 years and three months on one charge of scheming to perpetrate mail fraud & health care fraud, 19 health care fraud counts, one charge of scheming to reimburse illicit kickbacks to a prescriber, and eight charges of using the returns of health care fraud. Jeremy Adams had prior admitted guilty to the accusations in May 2020.
James A Mays, III, age 45, from Winfield, Alabama, was convicted to an imprisonment term of eight years and six months on one charge of scheming to perpetrate mail fraud & health care fraud, 12 health care fraud counts, and three money laundering counts based on using the returns of health care fraud. James Mays was the pharmacist who controlled the operations of the Global Compounding Pharmacy and amassed millions of U.S. dollars during the scheme. James Mays had prior admitted guilty to the accusations in Feb. 2021.
Jessica Linton, age 38, from Clearwater, Florida, was convicted to an imprisonment term of 11 years on one conspiracy count, thirteen health care fraud counts, three mail fraud counts, and seven aggravated identity theft counts. Jessica Linton was the manager leading Global Compounding Pharmacy’s billing center; she changed and added drugs, charged insurers for prescriptions that lacked medical necessity, and helped conceal the fraud scheme from auditors. Jessica Linto was convicted of these accusations in Feb. 2021 by a federal jury.
John Gladden, age 51, from Tallahassee, Florida, was convicted to an imprisonment term of five years and four months on one conspiracy count, six health care fraud counts, one mail fraud count, and one aggravated identity theft count. John Gladden, a Global Compounding Pharmacy’s district manager during most of 2015, instructed his salespersons to get prescriptions that lacked medical necessity for themselves and their kin and profited from the conspiracy. John Gladden was convicted of these accusations in Feb. 2021 by a federal jury.
Phillip Marks, age 52, from St. Augustine, Florida, was convicted to an imprisonment term of three years 36 months on one conspiracy count and twelve health care fraud counts. Phillip Marks worked as a supervisor of the sales managers and, in 2015, influenced subordinates to get prescriptions that lacked medical necessity for themselves and their kin. Phillip Marks amassed over 400,000 U.S. dollars during his period at Global Compounding Pharmacy. He had prior admitted guilty to the accusations in Sept. 2018.
The convictions came following a wide-ranging inquiry into a prescription medication billing conspiracy involving Northside Pharmacy, a pharmacy based in Haleyville, Alabama., d/b/a Global Compounding Pharmacy. Over two dozen accused persons admitted guilty to accusations, and two other accused persons went to trial in Feb. 2021.
Between 2013 and 2016, this extensive scheme charged insurers for huge quantities of prescription drugs that lacked medical necessity. The conspiracy involved instructing workers to get drugs that lacked medical necessity for themselves, kin, and friends, altering prescriptions to add non-prescribed medications since insurance would reimburse for them, repeatedly refilling prescriptions irrespective of patient need, regularly discounting and waiving co-payments to persuade patients to obtain and keep medically unnecessary medications, and charging for drugs without patients’ consent. Once prescription medication administrators tried to monitor this conduct, the schemers concealed their fraud and interfered with detection efforts, including by fibbing to auditors and redirecting their billing via affiliated pharmacies. The conspiracy targeted numerous health insurance programs, such as the pharmacy’s Blue Cross Blue Shield of Alabama program, along with plans offering health insurance to the disabled, elderly, veterans, and members of the military — TRICARE, Medicare, Medicaid, and CHAMPVA, among others.
The conspiracy led to pharmacy benefit executives reimbursing Global Compounding Pharmacy approximately 50 million U.S. dollars in claims in just a period of two years. Global Compounding Pharmacy received over 13 million U.S. dollars from prescriptions directed by prescribers who were either reimbursed cash to prescribe them or whose partners served as Global Compounding Pharmacy salespersons. One nurse professional who prescribed prescriptions was reimbursed illicit kickbacks in paper bags full of thousands of U.S. dollars in cash and left in her vehicle. Global Compounding Pharmacy further received more than 8.4 million U.S. dollars for prescriptions Global Compounding Pharmacy workers got for themselves, including from physicians they had not seen/met as patients. Occasionally, Global Compounding Pharmacy was reimbursed as much as 30,000 U.S. dollars or more for a single compounded cream tube.
The Health & Human Services Department – Office of Inspector General, the Defense Criminal Investigative Service, the Federal Bureau of Investigation, the USPIS (U.S. Postal Inspection Service), and the Internal Revenue Service – Criminal Investigation carried out the matters’ investigation.
U.S. Assistant Attorneys Edward Canter, J.B. Ward, and Don Long handled the matters’ prosecutions. The U.S. Veterans Affairs Department – Office of Inspector General, Criminal Investigations Division, supported during the matters’ investigation.
Breaching the Controlled Substance Statute, the False Claim Act, and the Anti-Kickback Statute is harshly punished by the law. Besides, conspiracy to commit health care fraud like stealing taxpayer-funded health care programs, like the Medicare, TRICARE, or Medicaid programs, is a serious crime. Any person who executes these crimes violates the law and is sternly fined or punished if found liable of or pleads guilty to the accusations. When charged for these offenses, one must look for the best legal assistance or representation to defend, fight, and pursue their rights. You should hire our competent team of the best defense and criminal attorneys if you require the most exceptional legal assistance and representation, which guarantees positive results for your case. Health Care Fraud Group consists of a highly qualified team of lawyers with tremendous skills in handling Health Care Fraud-linked matters concerning Federal Health Care programs; they are highly informed about civil and federal matters. The attorneys are well-known across the nation due to their remarkable work and proficiency when tackling health care fraud investigations and cases. Our experienced attorneys are fully fitted out with prior knowledge of each phase of Health Care fraud protection, medical, and legal issues.
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