BOLTON, Miss. (WLBT) – A federal judge sentenced a Mississippi pharmacist to five years in prison for a multimillion-dollar scheme to defraud TRICARE and private insurance companies.
David “Jason” Rutland, 42, of Bolton, pleaded guilty to getting paid kickbacks to distributors for the referral of medically unnecessary prescriptions, U.S. Department of Justice said.
It resulted in more than $180 million in fraudulent billings, including more than $50 million paid by federal health care programs.
According to court documents, the pharmacist and co-owner of compounding pharmacies schemed to defraud TRICARE and other health care benefit programs by distributing medically unnecessary compounded medications.
TRICARE is a health care program for uniformed service members, retirees, and their families.
Rutland adjusted prescription formulas to ensure the highest reimbursement, investigators said.
He’s also charged with soliciting recruiters to get prescriptions for high-margin compounded medications and paying those recruiters commissions based on the percentage of reimbursements paid by pharmacy benefit managers and health care benefit programs, such as TRICARE.
Rutland also routinely and systematically waived and reduced copayments to be paid by individuals, including utilizing a purported copayment assistance program to falsely make it appear as if his pharmacy and its affiliate compounding pharmacies had been collecting copayments.