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Three jailed over $54 million TRICARE healthcare fraud

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The Department of Justice has prosecuted three men over the fraud of TRICARE

Three men have been jailed over a $54 million fraud involving the healthcare company TRICARE.

TRICARE is a federal scheme that provides health insurance to active and retired service members and their families.

The men jailed are:

  • David Byron Copeland, 55, of Tallahassee, Florida
  • James Wesley Moss, 60, of Huntsville, Alabama
  • Michael Gordon, 60, of Fort Myers, Florida

Copeland was jailed for four years and three months, Moss for two years and three months, and Gordon for one year and six months for their roles in the fraud.

READ MORE: FTX Boss Faces 115 Year Jail Sentence For Massive Fraud

The court heard how Moss was a part-owner and CEO of Florida Pharmacy Solutions (FPS), a supplier of compounded prescription drugs.

Copeland was a co-owner and senior sales manager at the company and Gordon a lead sales representative.

The three, as well as accomplices, engaged in a practice called “test billing” to develop the most expensive combination of compounded drugs to maximize reimbursement from TRICARE.

They targeted physicians who treated TRICARE beneficiaries.

They paid bribes and kickbacks to physicians and salespeople to encourage the referral of prescriptions to FPS.

The bribes included expensive dinners and lavish hunting trips.

FPS employees also used “blanket letters of authorization”.

These allowed FPS to modify the prescription components to make them more profitable.   

It was found Moss paid Copeland and Gordon millions of dollars in kickbacks.

These were based on a percentage of how much TRICARE paid for their prescriptions.

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This meant they had an incentive to look for prescriptions for the compounded drugs possible, including pain and scar creams.

Copeland facilitated the kickbacks through companies he set up to receive and funnel the payments.

$54 million in three-year fraud

Between late 2012 and mid-2015, FPS billed TRICARE over $54 million for its compounded pharmaceuticals.   

Another man, Christopher White, was jailed for two years and nine months in April after admitting his role in the scheme.

Trial Attorneys Devon Helfmeyer, Clayton Solomon, and Katie Rookard of the Criminal Division’s Fraud Section prosecuted the case.

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