A Florida pharmacist and a pharmacy assistant were sentenced last week for their role in perpetrating a $30 million fraud against Tricare, the government’s health care program for military service members and veterans. According to the Department of Justice, the case was the largest ever health care fraud case involving Tricare to ever go to trial.
Following a nearly three-year investigation and a month-long trial in August of 2017, pharmacist Serge Francois and his assistant Patrick Tonge were found guilty of a number of counts related to health care fraud, kickbacks, money laundering, and the introduction of misbranded drugs into interstate commerce for their leading roles in the scheme. Francois, the owner / operator of Atlantic Pharmacy and Compounding, and Tonge worked with a number of “marketers” who paid physicians to write prescriptions for compounded topical medications that in some cases cost Tricare up to $17,000 per prescription. Many of the prescriptions were automatically refilled. And, as we’ve seen in a number of similar cases, Francois, Tonge and their co-conspirators utilized the prescription-writing services of physicians who never saw the patients for whom they were prescribing. Thousands of fraudulent claims were submitted to Tricare.
The fraud was quite lucrative. Evidence presented at trial indicted that Francois used the proceeds of the scheme to purchase a $3.6 million mansion once owned by Dwayne “the Rock” Johnson, a Ferrari, two Rolls-Royce motorcars, and a number of other luxury vehicles worth over $1 million.
Francois was sentenced to 204 months in prison, followed by three years supervised release, and was ordered to pay $31,259,252 in restitution. Tonge was sentenced to 188 months in prison, three years of supervised release, and was also ordered to pay $31,259,252 in restitution.
Following the sentencing, Defense Criminal Investigative Service Special Agent in Charge John F. Khin remarked, “This sentencing should serve as a stern warning to corrupt health care providers who defraud Federal health care programs. These defendants engaged in a vast and egregious fraud scheme that specifically targeted the vulnerabilities of the DoD’s TRICARE program, charging outrageous amounts for phony and unneeded prescription medications.”
“The sentence imposed today clearly demonstrates these crimes will not be tolerated and serves as a great deterrent to other healthcare providers engaging in these illegal schemes. Our federal government is vigilant against these crimes [and they] will be investigated and punished accordingly,” added Special Agent in Charge Christopher Cave of the U.S. Postal Service Office of the Inspector General Southern Area Field Office.