12 physicians, pharmacists indicted in $102M kickback scheme

Federal prosecutors indicted one dozen physicians, pharmacy owners and marketers for allegedly defrauding Tricare, the federal health program for military families, in a $102 million kickback scheme, USA Today reports.

The kickback scheme allegedly involved a Dallas-based firm called Compound Marketing Group, which paid physicians for prescribing compounded topical drugs, or personalized prescription creams, to Tricare beneficiaries, according to the report.

Walter Neil Simmons, MD, a Phoenix-based emergency medicine physician, allegedly created a fake study called the Patient Safety Initiative that paid Tricare patients $250 per month to obtain prescriptions from certain pharmacies. Dr. Simmons was indicted in October for conspiracy to commit healthcare fraud, according to the report.

Dr. Simmons also allegedly recruited William Elder-Quintana, MD, an El Paso, Texas-based physician, who wrote prescriptions totaling $96 million in costs to Tricare, according to the report. The indictment alleges Dr. Elder-Quintana and other physicians involved in the scheme were paid by the prescription.

The marketing representatives involved in the scheme allegedly called Tricare's pharmacy-benefits consultant to maximize payments from the health program, according to the report.

Read the full story here.


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