On June 16, 2023, the U.S. Department of Justice (“DOJ”) announced the conviction of David Copeland for his involvement in a substantial kickback and bribery scheme to defraud TRICARE, the federal program that provides health insurance benefits to many American service members.

According to a DOJ press release, Mr. Copeland was found guilty of orchestrating a complex scheme that revolved around fraudulent prescriptions. Specifically, the scheme involved soliciting and receiving illegal bribes and kickbacks from healthcare providers and pharmacies in exchange for steering patients to obtain fraudulent prescriptions.  According to the government, these prescriptions were medically unnecessary or were obtained through fraudulent means, leading to potential financial losses to TRICARE and potential harm to patients.

Citing court documents and trial evidence, the DOJ’s press release notes that Mr. Copeland was a part-owner and senior sales manager at Florida Pharmacy Solutions (FPS), a Florida-based pharmacy that specialized in compounded prescription drugs.  The investigation revealed an extensive network of individuals involved in the scheme, including doctors, pharmacists, and patients.  Mr. Copeland particularly targeted physicians treating TRICARE beneficiaries and paid bribes and kickbacks to encourage referrals to FPS, according to the government.  The bribes and kickbacks were not limited to direct payments.  Instead, the government alleges that lavish hunting trips and dinners amounted to bribes and kickbacks too.

Besides bribes and kickbacks, the DOJ alleges that Mr. Copeland (and his accomplices) engaged in “test billing” to identify the combination of compounded drugs that would provide the highest reimbursement rates.  Over three years, FPS billed TRICARE over $54 million.  Mr. Copeland and his accomplices also used “blanket letters of authorization,” which allowed FPS to modify prescriptions and compound components to make them more profitable, according to the government. 

Mr. Copeland was convicted of soliciting and receiving illegal health care kickbacks (two counts) and offering and paying illegal health care kickbacks (three counts).   He faces up to ten years in prison for each kickback count, but a federal judge will determine the appropriate sentence after considering the federal Sentencing Guidelines and other factors.  Interestingly, the jury acquitted Mr. Copeland of conspiracy to defraud the United States and conspiracy to pay and receive illegal health care kickbacks.

The attorneys at Chilivis Grubman represent clients of all types and sizes in connection to health care fraud and government investigations. If you need assistance with such a matter, please contact us today.