It Was the Biggest Scam in Tricare’s History. Now Troops May Be Going to Jail

It Was the Biggest Scam in Tricare's History. Now Troops May Be Going to Jail

FILE PHOTO — A Naval reservist counts medicine tablets June 13, 2019, during the IRT at Ballard Memorial High School in Barlow, Ky. (U.S. Air National Guard/Senior Airman Sarah M. McClanahan) For those who saw a loophole, it was easy money. In 2013, a handful of pharmacy companies that make compounded medications — personalized dosages or formulas normally crafted for patients who can’t tolerate certain ingredients — discovered they could make treatments such as pain and scar creams, wound ointments and erectile dysfunction drugs, and market them to patients enrolled in Tricare . Then, they could bill the government a hefty sum, between $400 and $10,000 per prescription, making enough to cover the cost of beneficiaries’ co-payments, provide kickbacks to participating physicians and middlemen, and generously pad their own pockets. When the Defense Health Agency’s losses caused by these specious prescriptions topped nearly $1.5 billion in the first half of 2015, the Pentagon moved to restrict its coverage of all compounded medications. Related: Tricare No Longer to Cover Some Prescription Painkillers And the Justice Department began pursuing the unscrupulous pharmacists, doctors, marketers and salesmen involved, including military troops who saw the largest case of medical fraud in the Pentagon’s history as a chance to make cash on the side. As of May 2019, the Justice Department has indicted and sentenced 74 people, with 50 more convicted and awaiting sentencing in the nationwide scheme perpetrated by at least 100 pharmacies. The criminals include at least five veterans, with more arrests of former service members possibly to come. The most recent veteran to be convicted is former Marine Bradley White of Oakley, California, who pleaded guilty in July to conspiracy to commit health care fraud. White worked with a team to recruit and pay Marines and dependents to accept medications compounded […]

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