The US Department of Justice (DOJ) announced on June 8, 2023 that Steven King, a compliance executive of pharmacy holding company A1C Holdings LLC, was convicted of defrauding Medicare out of more than $50 million in a scheme involving dispensing medically unnecessary lidocaine and diabetic testing materials.
King was one of five individuals charged by DOJ in 2019 with conspiracy to commit healthcare fraud and wire fraud. Three of those individuals pleaded guilty prior to King’s conviction, and the fourth is set to be tried in September 2023. The group operated a network of affiliated pharmacies in an effort to obscure the entities’ ownership. The fraud allegedly involved sending unwanted medications to patients and profiting from high reimbursement rates.
The pharmacies operated in Georgia, Kansas, Michigan, Missouri, Tennessee, Texas, and Virginia, and were falsely reported to payors as brick-and-mortar retail operations in an attempt to reduce government oversight, even though they delivered most of their prescriptions via mail, for which they were not authorized. King and his co-conspirators were also accused of taking other steps to conceal the Medicare fraud, including shipping refills and transferring patients among affiliated pharmacies without patient consent.
Source: Chief Compliance Officer Convicted in Healthcare Fraud Case / Morgan Lewis