Eleven Indicted For Conspiracy To Commit Healthcare Fraud Related To Kickbacks Involving Compounded Medication Prescriptions And Tricare Beneficiaries
Jacksonville, FL – United States Attorney Maria Chapa Lopez announces the return of an indictment charging Scott Balotin (49, Saint Johns), Greg Carter (62, Fleming Island), Thomas Jones (50, Jacksonville), John Clark Walton (49, Jacksonville), David Stevens (40, Callahan), Sam Todd (40, Jacksonville Beach), Derwin Allen (50, Jacksonville), and Pablo Ortiz (51, Middleburg) with conspiracy. Various defendants are also charged with multiple counts of receiving and paying kickbacks and/or money laundering. The maximum penalty for the conspiracy count and each count of money laundering is 10 years in federal prison. The maximum penalty for each count of receiving and paying kickbacks is 5 years in federal prison. The indictment also notifies the individuals that the United States intends to forfeit the proceeds traceable to the offense, as well as items and properties purchased with proceeds traceable to the offense, including a 2015 Cadillac Escalade, a 2015 Ford Thor Motor Coach, and two residences.
In a related case, a grand jury returned an indictment charging Qualla Miller (42, Orange Park), Earl Smalls (57, Jacksonville), and Mario Correa Jackson (35, Jacksonville) each with one count of conspiracy to commit health care fraud and separate counts of soliciting and receiving kickbacks. In addition, Smalls and Jackson were each charged with paying kickbacks, and Miller and Smalls were each charged with money laundering. The maximum penalty for the conspiracy count and each count of receiving and paying kickbacks is 5 years in federal prison. The maximum penalty for each count of money laundering is 10 years in federal prison. The indictment also notifies the individuals that the United States intends to forfeit the proceeds traceable to the offense.
According to the indictments, Balotin owned and operated Casepark, a marketing firm in Jacksonville that utilized sales representatives to market compounded medications, including creams for pain and scars, to health care benefit program beneficiaries. The creams had very high reimbursement rates, ranging from approximately $4,000 to $17,000 for a one-month supply. Casepark focused its promotional efforts on TRICARE beneficiaries, based upon an understanding and belief that TRICARE would pay claims for these compounded medications. The indictment alleges that a large number of the prescriptions generated for the recruited TRICARE beneficiaries were directed to Park and King Pharmacy, owned and operated by Greg Carter. Casepark received approximately 55 percent of the after-cost amount of each claim paid by a health care benefit program to Park and King Pharmacy for each prescription filled. Casepark, and Park and King, paid the sales representatives a percentage of the paid claims they received from the pharmacies.
To induce beneficiaries to provide their TRICARE information and obtain prescriptions for compounded creams from various doctors, patient recruiters (Jones, Walton, Stevens, Todd, Allen, Ortiz, Miller, Smalls, and Jackson) agreed to make, made, and caused to be made illegal kickbacks in the form of cash payments to the beneficiaries. Those prescriptions were filled at Park and King and other pharmacies and resulted in commission payments being made to Casepark and its sales representatives, including the defendants.
An indictment is merely a formal charge that a defendant has committed one or more violations of federal criminal law, and every defendant is presumed innocent unless, and until, proven guilty.
This case was investigated by the Internal Revenue Service - Criminal Investigation, the Defense Criminal Investigative Service, the Naval Criminal Investigative Service, the Jacksonville Sheriff’s Office, the Florida Department of Law Enforcement, and the United States Marshals Service. It will be prosecuted by Assistant United States Attorney Julie Hackenberry.