David “Jason” Rutland, 42, a pharmacist and co-owner of various compounding pharmacies, admitted to his role in a scheme that defrauded federal and privately-owned insurers by distributing medically unnecessary compounded medications and adjusting prescription formulas to ensure the highest reimbursement without regarding efficacy, according to the Department of Justice.
The scheme also defrauded insurers by soliciting recruiters to procure prescriptions for high-margin compounded medications and paying those recruiters commissions based on the percentage of reimbursements paid by pharmacy benefit managers and healthcare benefit programs. Under the scheme, copayments to be paid by beneficiaries and members were systematically waived and reduced.
Mr. Rutland pleaded guilty to conspiracy to defraud the U.S. and solicit, receive, offer and pay illegal kickbacks.
He faces a maximum penalty of five years in prison, and his sentencing hearing is scheduled for Nov. 30. Mr. Rutland will also have to pay restitution and forfeit all assets traced to his fraudulent gains.
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.