Three men were sentenced today in connection to a $54 million bribery and kickback scheme involving TRICARE, a federal program that provides health insurance benefits to active duty and retired service members and their families.
David Byron Copeland, 55, of Tallahassee, Florida, was sentenced to four years and three months in prison following his conviction at trial in June for paying and receiving health care kickbacks. James Wesley Moss, 60, of Huntsville, Alabama, and Michael Gordon, 60, of Fort Myers, Florida, were sentenced to two years and three months and one year and six months in prison, respectively, following their guilty pleas to a kickback and fraud conspiracy, among other charges.
According to court documents and evidence presented at trial, Moss was a part-owner and CEO of Florida Pharmacy Solutions (FPS), a Florida-based pharmacy that specialized in compounded prescription drugs. Copeland was also a part-owner and senior sales manager at FPS, and Gordon was a lead sales representative. Moss, Copeland, and Gordon, along with their accomplices, engaged in a practice known as “test billing” to develop the most expensive combination of compounded drugs to maximize reimbursement from TRICARE. Moss, Copeland, Gordon, and their accomplices targeted physicians who treated TRICARE beneficiaries and paid bribes and kickbacks to physicians and salespeople to encourage the referral of prescriptions to FPS. The bribes included lavish hunting trips and expensive dinners. In addition, FPS employees used “blanket letters of authorization” that allowed FPS to modify the prescription components to make them more profitable.
Moss paid Copeland and Gordon millions of dollars in kickbacks based on a percentage of the amount that TRICARE reimbursed for their prescriptions, which provided an incentive to seek prescriptions for the most expensive compounded drugs possible, including pain and scar creams. Copeland facilitated the kickbacks through companies he set up to receive and funnel the payments. From late 2012 through mid-2015, FPS billed TRICARE over $54 million for its compounded pharmaceuticals.
In April, co-defendant Edward Christopher White was sentenced to two years and nine months in prison after pleading guilty for his role in the scheme.
Acting Assistant Attorney Nicole M. Argentieri of the Justice Department’s Criminal Division; U.S. Attorney Roger Handberg for the Middle District of Florida; Special Agent in Charge Darrin K. Jones of the Department of Defense Office of Inspector General (DOD-OIG), Defense Criminal Investigative Service, Southeast Field Office; Acting Special Agent in Charge Stephen Mahmood of the Department of Health and Human Services Office of the Inspector General (HHS-OIG), Miami Regional Office; Special Agent in Charge David Spilker of the Department of Veterans Affairs Office of Inspector General (VA-OIG), Southeast Field Office; Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division; and Special Agent in Charge David Walker of the FBI Tampa Field Office made the announcement.
The DOD-OIG, HHS-OIG, VA-OIG, and FBI investigated the case.
Trial Attorneys Devon Helfmeyer, Clayton Solomon, and Katie Rookard of the Criminal Division’s Fraud Section prosecuted the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24.7 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.
Originally published at https://www.justice.gov/opa/pr/three-men-sentenced-54m-fraudulent-prescriptions-scheme