Four men and seven companies have been charged in a $1 billion telemedicine fraud scheme, according to the Department of Justice.
The four defendants Andrew Assad, Peter Bolos, Michael Palso and Larry Everett Smith were charged with conspiracy to commit healthcare fraud, mail fraud and introducing misbranded drugs into interstate commerce.
The seven companies involved in the scheme include Synergy Pharmacy Services, Precision Pharmacy Management, Tanith Enterprises, ULD Wholesale Group, Alpha-Omega Pharmacy and Zoetic Pharmacy. All the organizations are headquartered in Florida, aside from Zoetic Pharmacy, which is in Texas.
The men and their companies are accused of conspiring to deceive tens of thousands of patients and over 100 doctors in an effort to defraud payers (including Blue Cross Blue Shield of Tennessee) out of $174 million. The indictment alleges that the defendants submitted no less than $931 million in fraudulent claims for payment.
The scheme ran from June 2015 to April 2018.
According to the indictment, the defendants worked with telemedicine company HealthRight to fraudulently get insurance coverage information and prescriptions from patients for pain creams and other products. Physicians approved the prescriptions without knowing the defendants were hiking the prices of the invalidly prescribed drugs, which the defendants billed to private insurers.
HealthRight and its CEO Scott Roix pleaded guilty to felony conspiracy for their roles in the scheme. Roix and the company also pleaded guilty to conspiring to commit wire fraud in a different scheme for fraudulently telemarketing dietary supplements, skin creams and testosterone.
With locations in Pennsylvania and Texas, HealthRight acquired employer benchmarking firm HealthNEXT back in 2016.
HealthRight did not immediately respond to a request for comment.
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