A Mississippi pharmacist and co-owner of compounding pharmacies will serve five years in prison for a multimillion-dollar scheme to defraud TRICARE and private insurance companies.
Forty-two-year-old David "Jason" Rutland, of Bolton, Mississippi, pleaded guilty to charges of conspiracy to defraud the federal government, solicit, bribe, receive and pay kickbacks to distributors for the referral of medically unnecessary prescriptions.
“He solicited recruiters to procure prescriptions for high-margin compounded medications and paid those recruiters commissions based on the percentage of reimbursements paid by pharmacy benefit managers and health care benefit programs, including commissions on claims reimbursed by TRICARE,” the Department of Justice (DOJ)'s Health Insurance Newsletter said.
This resulted in over $180 million in fraudulent billings, according to the Health Insurance Newsletter.
“Rutland also routinely and systematically waived and/or reduced co-payments to be paid by beneficiaries and members, including utilizing a purported co-payment assistance program to falsely make it appear as if his pharmacy and its affiliate compounding pharmacies had been collecting co-payments, among other things,” the Health Insurance Newsletter said.
Rutland was ordered to pay restitution, and all assets traced to his ill-gotten gains will also be forfeited.
