Friday, August 18, 2023

Aiken Man Sentenced to Federal Prison for Role in Scheme to Defraud TRICARE

COLUMBIA, SOUTH CAROLINA —Travis Anthony Mason, 52, of Aiken, was sentenced to two and a half years in federal prison after pleading guilty to health care fraud.

Evidence presented to the court showed that Mason, through his company M3 Medical LLC, was involved in the marketing and sale of prescription compounded medications, which included various pain creams.  Compounded medications are specialty medications mixed by a pharmacist to meet the specific medical needs of an individual patient.  Although compounded drugs are not approved by the Food and Drug Administration (FDA), they are properly prescribed when a physician determines that an FDA-approved medication does not meet the health needs of a particular patient because, for example, the patient is allergic to a dye or other ingredient or requires the medication in a different form.

Mason and his coconspirators would target individuals with federally funded health insurance plans, including TRICARE, that provided benefits for the compounded prescriptions.  They would obtain prescriptions for compounded medications, many of which were medically unnecessary, from a physician.  They would then direct that these prescriptions be filled by specific compounding pharmacies.

Mason and his coconspirators knew that the compounded medication would yield a high reimbursement.  For every compounded prescription that was filled, Mason was paid a percentage of the reimbursement amount. Over two years, Mason and his coconspirators caused $1,966,194.00 in loss to TRICARE.

“Fraud of healthcare programs steals resources from people who need care and, in this case, from men and women who have bravely served our nation,” said U.S. Attorney Adair F. Boroughs.  “We appreciate the hard work of our agency partners in the investigation of this scheme, and we stand ready to prosecute those who steal from government programs to enrich themselves.”

“Travis Mason thought TRICARE and other Federal healthcare programs were easy targets for fraud; he was sorely mistaken,” said Special Agent in Charge Christopher Dillard, Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DCIS), Mid-Atlantic Field Office.  “Nationwide fraud schemes like this degrade our healthcare system.  They also put the public and the military at risk.  DCIS stands resolute with its Federal law enforcement partners to disrupt, dismantle, and prosecute perpetrators of these schemes.”

"Mason’s criminal acts jeopardized the health and well-being of unsuspecting victims, many of whom have served or continue to serve our country in the military,” Steve Jensen, Special Agent in Charge of the Columbia Field Office said. “Healthcare fraud remains a top priority for the FBI to investigate. We, along with our law enforcement partners, will take every measure available to unravel such schemes and bring perpetrators to justice."

United States District Judge Joseph F. Anderson sentenced Mason to 31 months in federal prison, to be followed by a three-year term of court-ordered supervision.  There is no parole in the federal system. The court also ordered him to pay the restitution in the amount of $1,966,194.00.

The case was investigated by the Department of Defense Office of Inspector General, Defense Criminal Investigative Service and the Federal Bureau of Investigation.  Assistant United States Attorney Amy F. Bower prosecuted the case.

 

 

Saturday, August 5, 2023

 

House Republicans Propose Drug Shortage Legislation ...

5 days ago — The bill will also allow compounding pharmacies to mix medicines 30 days after it has been listed on the FDA's database of drugs that are in shortage.

 

Prescription Drug Benefit Summary

2 days ago — This plan includes coverage for prescription drugs and certain other ... **Compounded medications are subject to a prior authorization process.

 

August 2023 – Rules - Ohio Board of Pharmacy

1 day ago — pharmacy licensed as a terminal distributor of dangerous drugs shall: ... (5) Maintain a stock of drugs sufficient to compound and prepare the types of ...

 

4. Program Regulations 130 CMR 406.000

2 days ago — Compounded Drug – any drug, excluding cough preparations, in which two or more active ingredients, at least one of which is a drug, are extemporaneously mixed ..

Bulk Drug Substances Currently Under Review

 


FDA‑2018‑N‑4626‑0106

https://www.fda.gov/animal-veterinary/animal-drug-compounding/bulk-drug-substances-currently-under-review
https://www.fda.gov/animal-veterinary/animal-drug-compounding/bulk-drug-substances-currently-under-review

 

Mark Cuban Cost Plus Drugs inks partnership with pharmacy navigation startup Scripta

By Anastassia Gliadkovskaya

Scripta will integrate Cost Plus Drugs’ discounted pricing into its platform to help members understand their medication options.

Wednesday, July 26, 2023