A Tennessee man who is one of several former medical sales representatives accused of participating in an Arkansas-based scheme to defraud Tricare, the U.S. military's health insurer, was sentenced Wednesday to 28 months in federal prison.
U.S. District Judge Brian Miller sentenced Jason Greene of Nashville after his pre-indictment guilty plea Nov. 26 to a charge of conspiring to violate the anti-kickback statute.
Assistant U.S. Attorney Alex Morgan wrote in a sentencing memorandum that Greene "got over $765,000 in kickbacks for recruiting TRICARE beneficiaries to receive expensive prescription drugs; he kept nearly $600,000 for himself and paid the rest to his own web of seven patient recruiters. All told, [Greene] and his seven subordinates recruited over fifty TRICARE beneficiaries from around the country who together received over $3.8 million in compounded prescription drugs."
Federal prosecutors have said that an Arkansas conspiracy to generate unnecessary prescriptions for expensive compounded drugs -- mostly pain cream, scar cream and supplements -- was carried out from roughly December 2014 through July 2015 under the direction of Brad Duke, a Little Rock man who is one of many to plead guilty in the conspiracy case so far but who hasn't yet been sentenced.
The scheme was one of many across the country that the FBI and the U.S. Department of Health and Human Services' Office of Inspector General ferreted out after Tricare paid nearly $2 billion for compound prescriptions in 2015, representing an 18-fold increase over previous years and setting off alarms.
Morgan has said that Tricare beneficiary information provided to Duke from his network of recruiters was turned over to a Conway woman, Charlotte Leija, who used the information to write fake prescriptions for those people under the name of a doctor for whom she worked as a medical assistant. Prosecutors say the doctor was unaware of the scheme. Leija pleaded guilty and is serving an 18-month sentence.
The prescriptions were then filled at a Mississippi compounding pharmacy that paid Duke about 35% of the sales he generated for the pharmacy. Over 70% of the prescriptions that were issued went to Tricare beneficiaries outside Arkansas, in 24 states from California to Massachusetts, who continued to receive refills every month despite not needing the product, each time generating kickbacks to Duke and his network.
Morgan, who has prosecuted all of the Arkansas cases, said in a sentencing memo prepared in advance of Greene's sentencing that Greene knew from "Day One" that the patients would never consult a doctor and that "prescriptions would be rubber-stamped without regard for medical necessity."
Morgan said that text messages Greene sent to others involved in the scam proved that he understood that.
"Although not themselves veterans of the medical sales industry, common sense led many of his own subordinates to ask [him] who was signing prescriptions," Morgan wrote. "His response was to lie."
Morgan said Greene found people with military ties to recruit patients for him. He wrote, "One was approached while working at a Nashville bar after [Greene] noticed the military tattoos on his arm. Another, a Marine, recalled [Greene] encouraging him to recruit by telling how 'some other guy in the Army made a killing signing up his platoon when he got home from overseas.'"
Morgan said Greene reassured his questioners that the operation was "very legit" and that he worked with credible doctors, and implied that he had close relationships with them.
But, Morgan said, "with signatures automatic, it was [Greene] ... who chose what to prescribe and for whom."
He "did not so much recruit patients as he did generate prescriptions with knowledge each and every one would be rubber stamped despite the absence of any corresponding medical information about the underlying 'patient,'" Morgan said. "And the rate at which he did so was staggering."
The prosecutor wrote that over three months in 2015, Greene emailed more than 75 pre-filled prescriptions, with 20 of those prescriptions sent on one day in March. Each prescription, he said, called for three drugs, the most that Tricare would cover.
As an example, Morgan said records showed that on April 23, 2015, a subordinate of Greene's texted beneficiary information to him. The next day, Greene sent in a prescription for pain cream, scar cream and supplements -- "the most profitable three-drug combination possible -- for which TRICARE would go on to pay $39,652.12 for one-month's supply, earning [Greene] $7,930.42."
Morgan wrote that Greene wasn't concerned about whether the beneficiaries actually needed the drugs, telling one subordinate that if the recipients "didn't like them, they could trash them," but he would "let them keep coming."
He said Greene later instructed his subordinates to "cut them [beneficiaries] in on the money" to keep them from raising an alarm.
Morgan said Greene "brushed aside" subordinates' continued questions about whether the setup was legal by saying, "Yes. It's TRICARE, so it's through the government. The doctor is signing off on it. Everything is okay."
Metro on 07/26/2019