The federal government takes fraud seriously, and Michigan defendants facing these allegations also face the possibility of extensive time behind bars. A former pharmacist is expected to spend up to a decade in a federal penitentiary after he was sentenced for his role in a false billings scheme that took place while operating multiple pharmacies. He was arrested for health care fraud, specifically due to millions of dollars in claims to private insurance companies and the TRICARE federal insurance program. He previously plead guilty to conspiracy.
Details of a health care fraud scheme
According to the prosecution, the pharmacist committed fraud by distributing medically unnecessary medications to patients. At the time, he owned multiple compounding pharmacies. Compounded medication is tailor-made to the specific patient, and the pharmacist and his partner were accused to taking advantage of this opportunity by making unnecessarily expensive medications and then billing insurance companies for exorbitant amounts of money.
The two men could make compounds that would maximize their reimbursement from insurance companies. They also marketed these medications to doctors, and they would occasionally change the formula as reimbursement rates changed. The scheme also used recruiters who could get paid for bringing in new prescriptions to be filled.
A defense against fraud charges
Health care fraud is a serious type of financial crime, and the implications are grave. Those in Michigan facing these charges could possibly spend decades behind bars if convicted of these crimes. It is in the interests of anyone facing allegations of fraud or under investigation for any type of white collar crime to seek the immediate guidance of an experienced federal criminal defense attorney.