A federal judge in Greeneville, Tennessee, sentenced seven people and seven related corporate entities for deceiving pharmacy benefit managers (PBMs) regarding tens of thousands of prescriptions. The scheme involved using telemedicine to authorize prescriptions and gain insurance information.
The leader in the fraud scheme, Peter Bolos, was convicted in December by a federal jury. They found that Bolos, along with co-conspirers Michael Palso, Andrew Assad, Scott Roix, Larry Smith, Mihir Taneja, Arun Kapoor, and Maikel Bolos defrauded PBMs, such as Express Scripts and CVS Caremark, leading them to authorize claims for prescription drugs that insurers paid to pharmacies the conspirators controlled.
Bolos received a 14-year prison sentence and $2.5 million in forfeiture on May 16. The court also sentenced Palso to nearly three years in prison. The two individuals will each pay $25 million in restitution.