On January 26, the Department of Justice announced the 5-year prison sentence of a Mississippi pharmacist for a multimillion-dollar scheme to defraud TRICARE and private insurance companies. David “Jason” Rutland was found to have paid kickbacks to distributors for referring medically unnecessary prescriptions. According to the DOJ, Rutland’s actions resulted in $180 million in fraudulent billings, which included over $50 million paid by federal health care programs.
According to investigators, Rutland adjusted prescription formulas to ensure the highest reimbursement possible. Rutland was also accused of soliciting recruiters to obtain prescriptions for high-margin compounded medications. He then paid those recruiters commissions based on the percentage of reimbursements paid by pharmacy benefit managers and health care benefit programs such as TRICARE, a health care program for uniformed service members, retirees, and their families.
Investigations revealed evidence that Rutland also “routinely and systematically” waived and/or reduced copayments, utilizing a purported copayment assistance program to make it appear as if his pharmacy and its affiliate compounding pharmacies indeed had been collecting copayments.
Rutland pleaded guilty on July 20, 2021 to conspiracy to defraud the United States and solicit, receive, offer, and pay illegal kickbacks. In addition to his 5-year prison sentence, a federal judge ordered Rutland to pay restitution and forfeit all assets traced to the gains surrounding his case.
The attorneys at Chilivis Grubman represent clients of all types and sizes in connection with criminal healthcare fraud and government investigations. If you need assistance with such a matter, please contact us today.