{"id":72030,"date":"2022-01-28T18:56:04","date_gmt":"2022-01-28T18:56:04","guid":{"rendered":"https:\/\/one.sightlinemg.com\/navytimes\/uncategorized\/2022\/01\/28\/florida-man-guilty-in-88-million-drug-scheme-targeting-tricare-va\/"},"modified":"2026-08-08T14:25:03","modified_gmt":"2026-08-08T14:25:03","slug":"florida-man-guilty-in-88-million-drug-scheme-targeting-tricare-va","status":"publish","type":"post","link":"https:\/\/one.sightlinemg.com\/navytimes\/veterans\/2022\/01\/28\/florida-man-guilty-in-88-million-drug-scheme-targeting-tricare-va\/","title":{"rendered":"Florida man guilty in $88 million drug scheme targeting Tricare, VA"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">A South Florida man pled <a href=\"https:\/\/www.militarytimes.com\/veterans\/2021\/12\/08\/four-sentenced-in-fraudulent-va-construction-scheme\/\" target=\"_blank\">guilty<\/a> for his part in a multi-million dollar <a href=\"https:\/\/www.militarytimes.com\/news\/2022\/01\/25\/she-helped-15-million-tricare-fraud-scheme-to-push-unneeded-drugs-on-vets\/\" target=\"_blank\">fraud<\/a> <a href=\"https:\/\/www.militarytimes.com\/veterans\/2021\/10\/19\/army-vet-accused-of-faking-paralysis-to-get-1-million-in-va-benefits-using-some-to-buy-bmw\/\" target=\"_blank\">conspiracy<\/a> that provided prescription drugs designed to maximize his pharmacy\u2019s profit but had little medical value, the Justice Department <a href=\"https:\/\/www.justice.gov\/usao-sdfl\/pr\/former-south-florida-pharmacy-executive-pleads-guilty-88-million-health-care-fraud\" target=\"_blank\">says<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">58-year-old Matthew Smith of Palm Beach, Florida, pled guilty to one count of health care fraud on Jan. 26, before a federal judge in Miami, Florida. Smith was a part of conspiracy that defrauded Tricare and the Department of Veterans Affairs\u2019 Civilian Health and Medical Program of $88 million, prosecutors say. Smith is scheduled to be sentenced April 5, and he faces up to 10 years in prison.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Smith pled guilty \u201cfor his abhorrent conduct in defrauding multiple federal healthcare programs meant to benefit deserving veterans and their families,\u201d Special Agent in Charge David Spilker of the Department of Veterans Affairs Office of Inspector General\u2019s Southeast Field Office said in a release.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Smith acknowledged that while working as the executive vice president of a Broward, Florida pharmacy, he fraudulently billed both Tricare and CHAMP VA $88 million for \u201cmedically unnecessary\u201d drugs known as compounded medications.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Compounded medication combines two or more drugs to meet specific patient needs, according to the Food and Drug Administration. It can be as simple as turning a prescription from a pill to a liquid form or removing a particular dye or ingredient to which a patient is allergic. However, once a medication is compounded, it loses FDA approval.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">As part of the scheme, Smith and his co-conspirators then paid approximately $40 million in \u201ckickbacks\u201d to patients, patient recruiters, and doctors in exchange for them to purchase scar creams, pain creams, and vitamins, prosecutors say. He also ensured that the compounded drugs sold from his pharmacy were formulated to maximize profit, while the drugs had no legitimate therapeutic value.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Healthcare fraud writ large is not unique to government health care programs. <a href=\"https:\/\/www.nhcaa.org\/tools-insights\/about-health-care-fraud\/the-challenge-of-health-care-fraud\/\" target=\"_blank\">According<\/a> to the National Heal Care Anti-Fraud Association, as much as 10% of total health care expenditures, some $300 billion annually, are a result of fraud.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The military has been hit hard, according to investigators.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cCompounding pharmacy fraud bilked the Defense Health Agency of over a billion dollars and exploited not only the military but all citizens,\u201d said DCIS Special Agent in Charge Bruce.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A July annual joint <a href=\"https:\/\/www.nhcaa.org\/tools-insights\/about-health-care-fraud\/the-challenge-of-health-care-fraud\/\" target=\"_blank\">report<\/a> from the Department of Health and Human Services and DOJ identified at least $780 million in fraud emanating from compound medications, with at least $750 million of the fraud directed at Tricare.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562881\/\" target=\"_blank\">According<\/a> to the National Institute of Health, tracking compound medication fraud is complex due to a lack of reporting requirements. Nevertheless, NIH reports that compounding medications are \u201can increasingly lucrative industry,\u201d with global market revenue for legitimate sales ranging from $2 billion to $9 billion annually.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cFraudsters steal exorbitant amounts of money from our government health programs through prescription medication fraud schemes,\u201d said U.S. Attorney Gonzalez. \u201cThose who use kickback payments and fraudulent billing activities to defraud vital public programs will be held accountable.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Justice Department says that the compounded drugs prescribed were &#8220;medically unnecessary&#8221; and were formulated to &#8220;maximize profit.&#8221;<\/p>\n","protected":false},"author":7,"featured_media":105937,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_yoast_wpseo_meta-robots-noindex":"","_yoast_wpseo_meta-robots-nofollow":"","_yoast_wpseo_canonical":"","_acf":"","_yoast_wpseo_primary_category":19,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","_smg_distribution_targets":[]},"categories":[101,23,89,12,26,62,19],"tags":[],"coauthors":[3328],"class_list":["post-72030","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-daily-news-roundup","category-home","category-middle-column","category-news","category-newsletters","category-pentagon-congress","category-veterans"],"acf":{"subheadline":"","legacy_arc_id":"OTBYMHSAS5EGNJQGBMMAO22EOI","arc_canonical_url":"\/veterans\/2022\/01\/28\/florida-man-guilty-in-88-million-drug-scheme-targeting-tricare-va\/","remove_feature_photo":false,"is_sponsored":false,"subtype":"","redirect_url":"","disable_inline_ads":false,"native_logo_pretext":"Presented By:"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.0 (Yoast SEO v28.1) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Florida man guilty in $88 million drug scheme targeting Tricare, VA - Navy Times<\/title>\n<meta name=\"description\" content=\"The Justice Department says that the compounded drugs prescribed were &quot;medically unnecessary&quot; and were formulated to &quot;maximize profit.&quot;\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/one.sightlinemg.com\/militarytimes\/news\/your-military\/2022\/01\/28\/florida-man-guilty-in-88-million-drug-scheme-targeting-tricare-va\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Florida man guilty in $88 million drug scheme targeting Tricare, VA\" \/>\n<meta property=\"og:description\" content=\"The Justice Department says that the compounded drugs prescribed were &quot;medically unnecessary&quot; and were formulated to &quot;maximize profit.&quot;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/one.sightlinemg.com\/navytimes\/veterans\/2022\/01\/28\/florida-man-guilty-in-88-million-drug-scheme-targeting-tricare-va\/\" \/>\n<meta property=\"og:site_name\" content=\"Navy Times\" \/>\n<meta property=\"article:published_time\" content=\"2022-01-28T18:56:04+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-08T14:25:03+00:00\" \/>\n<meta name=\"author\" content=\"James R. 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