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Five charged in $1 billion healthcare fraud scheme

Matthew Lane • Updated Oct 19, 2018 at 12:56 PM

GREENEVILLE — A 32-count indictment has been filed in federal court against four individuals and seven companies in a $1 billion health care fraud scheme.

In addition, the court also unsealed an additional two plea agreements and an information charging a fifth person and his company for their role in the scheme.

DEFENDANTS CHARGED

Named in the court documents are Andrew Assad, 33, of Palm Harbor, Florida; Peter Bolos, 41, of Lutz, Florida; and Michael Palso, 44, of Odessa, Florida, along with their compounding pharmacies: Synergy Pharmacy Services and Precision Pharmacy Management.

Co-conspirator Larry Everett Smith, 48, of Pinellas Park, Florida, and his companies Tanith Enterprises, ULD Wholesale Group, Alpha-Omega Pharmacy, Germain Pharmacy and Zoetic Pharmacy were all also named as defendants.

According to court records, all the defendants were charged with conspiracy to commit health care fraud, mail fraud and introducing misbranded drugs into interstate commerce.

Scott Roix, 52, of Seminole, Florida, and the CEO of HealthRight (a telemedicine company) pleaded guilty to felony conspiracy for his role in the scheme. Roix also pleaded guilty to conspiring to commit wire fraud in a separate scheme for fraudulently telemarketing dietary supplements, skin creams and testosterone.

ABOUT THE CASE

According to the indictment, from June 2015 through April 2018, these defendants and companies conspired to deceive tens of thousands of patients and more than 100 doctors in East Tennessee and across the country by defrauding private health care benefit programs such as Blue Cross Blue Shield of approximately $174 million.

The indictment further alleges that the defendants submitted at least $931 million in fraudulent claims for payment.

Prosecutors say the defendants set up an elaborate telemedicine scheme where HealthRight fraudulently solicited insurance coverage information and prescriptions from consumers across the country for prescription pain creams and other similar products.

Doctors approved the prescriptions without knowing that the defendants were massively marking up the prices of the invalidly prescribed drugs, which the defendants then billed to private insurance carriers, court records state.

Assad, Bolos, Palso, and Smith appeared in court earlier this month in U.S. District Court in Florida. All four were released on bond and are scheduled for an initial appearance in U.S. District Court in Greeneville later this month.

If convicted, Assad, Bolos, Palso, and Smith face up to 20 years in prison and fines up to $250,000. The indictment also seeks the forfeiture of approximately $154 milion. Roix and HealthRight pleaded guilty. He faces a maximum sentence of five years in prison. A sentencing has been scheduled for February 13, 2019.

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