Pensacola pharmacy owner convicted of TRICARE fraud, money laundering

Pensacola pharmacy owner convicted of TRICARE fraud, money laundering

In exchange for recruiting the TRICARE beneficiaries, Burton received about half of the amount paid to Fisher in insurance reimbursements. Those commission payments were laundered in the form of large wire transfers and direct deposits into Burton’s bank account in Georgia. Fisher agreed to fill prescriptions at Physician Specialty Pharmacy from a doctor’s office in Georgia whose beneficiary information was provided by Burton and individuals working for him, even though the patients had never seen that doctor and the prescriptions were not based on a legitimate doctor-patient relationship. As part of the scheme, Fisher, who is not a licensed pharmacist, directed his employees to use ingredient formulations for the drugs that would maximize the amount his pharmacy could bill to TRICARE and other insurance companies. That could amount to upwards of $10,000 to $17,000 per medication.

Indicted:Pensacola pharmacy co-owner indicted in federal court on fraud charges Conviction:Pensacola pharmacy owner convicted in federal court on fraud charges

According to prosecutors, between October 2014 and December 2015, Fisher conspired with sales representative Michael Scott Burton and others to defraud TRICARE out of more than $4.8 million in fraudulent claims for prescription compounded pain cream, scar cream and wellness vitamins.  As part of his sentence, Fisher, who was the owner and operator of Physician Specialty Pharmacy in Pensacola, was ordered to pay more than $4.8 million in restitution to TRICARE and forfeit a more than $3.8 million money judgment. 

Source www.pnj.com

Burton was sentenced in August 2019 to eight years in federal prison after he was convicted of money laundering, conspiracy to commit health care fraud and wire fraud, and conspiracy to commit money laundering. Fisher also directed Burton and his employees to tell patients not to worry about co-payments to ensure they would not decline receiving the medications over out-of-pocket cost.

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