Plot to defraud Tricare stacks up guilty pleas; Arkansas man 6th to plead

Guilty pleas are continuing to stack up in Little Rock in a federal investigation into a multimillion dollar scheme to defraud Tricare, the U.S. military's health insurer.

Brian Means, a former medical sales representative in Fort Smith, on Wednesday became the sixth person in eight weeks to admit to participating in a conspiracy that U.S. Attorney Cody Hiland says generated more than $10 million in prescriptions for compounded drugs in a year's time.

In a joint announcement last month with the FBI and the U.S. Department of Health and Human Services, Hiland noted that nationally, Tricare paid nearly $2 billion for compound prescription drugs in 2015, which constituted an 18-fold increase over previous years and prompted investigations around the country.

The investigation in the Eastern District of Arkansas has so far prompted guilty pleas to violations of the anti-kickback statute from Brad Duke, a 43-year-old medical sales representative in Little Rock, and five others who have admitted to helping him generate prescriptions for people with Tricare insurance.

Duke promoted prescription pain cream, scar cream and supplements for a Mississippi-based compounding pharmacy, which paid him a share of whatever the pharmacy was paid on prescriptions issued by affiliated doctors, Hiland said. The pharmacy hasn't been identified.

Means is listed in court documents as one of several patient recruiters who worked as medical sales representatives in different cities -- Maumelle; Little Rock; Nashville, Tenn.; Fort Smith; and McKinney, Texas. Prosecutors say Means paid the patient recruiters to find Tricare beneficiaries and forward their insurance information to Duke, which he routed to a local medical assistant, Charlotte Leija, whom he paid to file the prescriptions under the name of a doctor for whom she worked.

Court documents say the conspiracy was carried out from about December 2014 until about July 2015. Prior to December 2014, they say, a medical sales company in Tennessee struck an agreement with the pharmacy to market its compounded medications. In November 2014, records show, the president of the Tennessee company engaged Duke, who was doing business as Medsurg, telling him the marketing job was lucrative because Tricare paid tens of thousands of dollars per month, per patient, for its products, and the pharmacy issued monthly refills automatically without enforcing co-payment collections, allowing the beneficiaries to continue receiving monthly shipments at no cost to themselves.

Duke, in turn, enlisted several people to help him earn 35 percent of whatever sales he generated for the pharmacy, documents show.

As part of his plea agreement, Means agreed to repay the U.S. Treasury $198,799 on a schedule, beginning with a payment Wednesday for $107,000. Another $48,000 is due by Dec. 10 and the remaining $43,799 is due by Jan. 14 2019, according to his plea agreement.

Metro on 11/30/2018

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