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Monday, December 6, 2021
Saturday, December 4, 2021
Thursday, December 2, 2021
Department of Justice
Louisiana Marketer Sentenced in More Than $180 Million Health Care Fraud Scheme
A Louisiana marketer was sentenced today to 30 months in prison in the Southern District of Mississippi for his role in a multimillion-dollar scheme to defraud TRICARE and private insurance companies by paying kickbacks to distributors for the referral of medically unnecessary prescriptions. TRICARE is the health care program for uniformed service members, retirees and their families. The conduct resulted in more than $180 million in fraudulent billings, including more than $50 million paid by federal health care programs.
According to court documents, Thomas “Tommy” Wilburn Shoemaker, 57, of Rayville, participated in a scheme to defraud TRICARE and other health care benefit programs by acting as a marketer for a network of pharmacies owned and operated by co-conspirators Mitchell “Chad” Barrett and David Jason Rutland. Shoemaker worked with the pharmacies to use his TRICARE insurance to adjust prescription formulas to ensure the highest reimbursement without regard to efficacy, and he recruited doctors to procure prescriptions for high margin compounded medications. Shoemaker also obtained numerous fraudulent prescriptions using the personal information of military acquaintances.
Shoemaker pleaded guilty on Aug. 12 to conspiracy to defraud the United States and solicit, receive, offer, and pay illegal kickbacks. In addition to the term of imprisonment, Shoemaker was ordered to pay restitution and forfeit all assets traced to his ill-gotten gains.
Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division; U.S. Attorney Darren J. LaMarca for the Southern District of Mississippi; Acting Assistant Director Jay Greenberg of the FBI’s Criminal Investigative Division; and Special Agent in Charge Cyndy Bruce of the Department of Defense Office of Inspector General’s Defense Criminal Investigative Service (DoD OIG-DCIS) Southeast Field Office made the announcement.
The FBI Jackson Field Office and DoD OIG-DCIS are investigating the case.
Trial Attorneys Emily Cohen and Alejandra Arias of the Criminal Division’s Money Laundering and Asset Recovery Section and Assistant U.S. Attorney Kathlyn Van Buskirk of the Southern District of Mississippi are prosecuting the case with assistance from Sara Porter and Dustin Davis from the Criminal Division’s Fraud Section.
BOARD REVISES PROCESS FOR APPROVAL OF PHARMACIST:TECHNICIAN RATIO REQUESTS. The North Carolina Pharmacy Practice Act provides that “a pharmacist may not supervise more than two pharmacy technicians unless the pharmacist-manager receives written approval from the Board. The Board may not allow a pharmacist to supervise more than two pharmacy technicians unless the additional pharmacy technicians are certified pharmacy technicians.” G.S. 90-85.15A(c)). In light of changes to the North Carolina Pharmacy Practice Act granting qualified pharmacy technicians the authority to administer certain vaccines under pharmacist supervision, and (effective February 1, 2022) expansion of pharmacist’s ability to initiate and modify certain drug therapies, the Board has modified its process for reviewing and approving pharmacist:technician ratio requests.
A pharmacist-manager’s request for a 1:3, 1:4, or 1:5 pharmacist:technician ratio may be allowed by Board staff without formal Board action as long as the pharmacist-manager demonstrates that the pharmacy employs a sufficient number certified technicians to meet the ratio. A pharmacist-manager’s request for a 1:6 or higher pharmacist:technician ratio must be considered by the full Board.
More detail on the Board’s revised process, as well as instructions on how to submit a pharmacist:technician ratio request, is found here.
quoted from http://www.ncbop.org/
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