Court rules: Major healthcare fraud

Madison County Mississippi pharmacy owner Thomas Edward Spell Jr. was sentenced to spend 10 years in prison for his role in what is believed to the largest healthcare fraud cause ever discovered in the Magnolia State, totaling some $243M in fraud. The investigation is ongoing and prosecutions are continuing nationwide, including in states such as California, Tennessee, Arkansas, and Connecticut. Spell and his co-conspirators waived TRICARE’s requirement that a beneficiary make a copayment to receive medicine. Instead, Spell and his co-conspirators had their employees purchase prepaid debit cards and money orders to use towards a copayment for a beneficiary, with Spell and his co-conspirators reimbursing their employees. They also paid kickbacks and bribes to marketers to obtain prescriptions for compounded medications from prescribers. The defendant "ripped off every single military service member, veteran and American taxpayer when he defrauded TRICARE," said prosecuting attorney Mike Hurst. Co-conspirators Gregory Auzenne, M.D., 49, and Tiffany Clark, 45, both of Meridian, were charged for their alleged participation in a scheme to defraud TRICARE. The indictment alleges that Auzenne and Clark caused the submission of over $1.6M in fraudulent claims to TRICARE. (Soource: Magnolia State 11/01/20)