A federal judge sentenced a Mississippi pharmacist to five years in prison for a multimillion-dollar scheme to defraud TRICARE and private insurance companies.
David “Jason” Rutland, 42, of Bolton pleaded guilty on July 21, 2021, to conspiracy to defraud the United States and solicit, receive, offer and pay illegal kickbacks.
It resulted in more than $180 million in fraudulent billings, including more than $50 million paid by federal health care programs.
According to court documents, Rutland, a pharmacist and co-owner of various compounding pharmacies, admitted that he participated in a scheme to defraud TRICARE and other health care benefit programs by distributing medically unnecessary compounded medications by, among other things: adjusting prescription formulas to ensure the highest reimbursement without regard to efficacy; soliciting recruiters to procure prescriptions for high-margin compounded medications and paying those recruiters commissions based on the percentage of reimbursements paid by pharmacy benefit managers and health care benefit programs, including commissions on claims reimbursed by TRICARE; and routinely and systematically waiving and/or reducing copayments to be paid by beneficiaries and members, including utilizing a purported copayment assistance program to falsely make it appear as if Rutland’s pharmacy and its affiliate compounding pharmacies had been collecting copayments.
TRICARE is a health care program for uniformed service members, retirees, and their families.