Mitchell Barrett was a licensed pharmacist and co-owner of compounding pharmacies. He participated in a scheme to defraud Tricare by paying kickbacks to distributors for the referral of medically unnecessary prescriptions, prosecutors said. Mr. Barrett and his co-conspirators submitted $180 million in fraudulent billings to federal and private insurers as a result of the scheme.
According to court documents, Mr. Barrett modified prescription formulas to guarantee the highest reimbursement regardless of medical necessity. He hired recruiters to obtain prescriptions for compounded medications, paying them commissions based on the percentage of reimbursements paid by pharmacy benefit managers and healthcare benefit programs.
Mr. Barrett also frequently waived and reduced copayments paid by beneficiaries and members. He used a purported copayment assistance program to make it seem as though his pharmacy and its affiliate compounding pharmacies had been receiving copayments, according to court documents.
Mr. Barrett pleaded guilty to the scheme Aug. 25.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
