WASHINGTON, D.C. (WHNT) — The United States Department of Justice (DOJ) said an Alabama man and two Florida men were sentenced on Tuesday for a $54 million bribery and kickback scheme.
James Wesley Moss, 60, of Huntsville, was sentenced to two years and three months after pleading guilty to a kickback and fraud conspiracy, among other charges.
He and two other defendants are said to have billed TRICARE, a federal program that provides health insurance benefits to active duty and retired service members and their families, over $54 million for its compounded pharmaceuticals.
According to court records, Moss’s role as part-owner and chief operating officer of Florida Pharmacy Solutions (FPS), which specializes in compounded prescription drugs, contributed to “TRICARE being unlawfully billed over $41 million dollars resulting in the payment of over $20 million dollars in unlawful kickbacks.”
Moss allegedly gained around $2 million dollars over several years from this illegal compounding fraud kickback scheme.
Michael Gordon, 60, of Fort Myers, Florida, also entered a guilty plea to kickback and fraud charges, and was sentenced to one year and six months in prison. David Byron Copeland, 55, of Tallahassee, Florida, was sentenced to four years and three months in prison after he was convicted at trial in June for paying and receiving health care kickbacks.
Court documents and evidence presented at trial show Copeland was also part-owner and senior sales manager at FPS, and Gordon was the lead sales representative.
Evidence was presented that states the three men and accomplices engaged in “test billing,” to develop the most expensive combination of compounded drugs in order 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 DOJ said in a release.
Those bribes reportedly included, “lavish hunting trips and expensive dinners.”
The DOJ says Moss paid Copeland and Gordon millions of dollars in kickbacks based on a percentage of the amount that TRICARE reimbursed for their prescriptions. These kickbacks provided incentives to seek prescriptions for the most expensive compounded drugs, 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,” the department says.
In April, the DOJ says another co-defendant, Edward Christopher White, was sentenced to two years and nine months in prison after pleading guilty for his role in the prescriptions scheme.