Mississippi pharmacy owner gets 10 years for $243M Tricare fraud scheme

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A Mississippi pharmacy owner was sentenced Oct. 31 to 10 years in prison for defrauding Tricare of $243 million, according to Fox Business.

Thomas Edward Spell Jr. owned several compounding pharmacies in Mississippi. Instead of mixing drugs based on physicians' recommendations, the pharmacy used formulas to maximize Tricare reimbursements and benefits from other health programs, prosecutors claimed.

Tricare requires its beneficiaries to make copays to receive their drugs, but Mr. Spell waived that requirement and directed employees to buy prepaid money orders to use toward the copays, according to Fox Business.

He also paid kickbacks and bribes to marketers to get prescriptions for compounded medications covered by Tricare.

Due to the fraudulent claims, Tricare reimbursed the pharmacies for more than $243 million. Mr. Spell personally reaped a profit of $29 million from the scheme. He used the money to buy boats, cars, property and to make investments in his name and family members' names.

The scheme took place between December 2014 and January 2016.

To date, prosecutors have charged 20 people in connection with the scheme. Fourteen have been convicted. The investigation is ongoing.

In addition to 10 years in prison, Mr. Spell was ordered to pay $243.5 million in restitution. Officials seized about $26 million from him during the investigation.

Read the full article here.

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