John Paul Cooper, TRICARE Fraud, Texas 2020

A former health care executive at the center of a $70 million compounded pain and scar cream fraud has been sentenced to 20 years in federal prison, announced U.S. Attorney for the Northern District of Texas Erin Nealy Cox.

In December 2019, after six days of deliberation, a federal jury convicted John Paul Cooper, 56, of one count of conspiracy to commit health care fraud, one count of receipt of illegal kickbacks, and six counts of payment of illegal kickbacks. Mr. Cooper was sentenced Tuesday by Chief U.S. District Judge Barbara M.G. Lynn.

“This defendant siphoned millions of dollars from Defense Department’s health insurance program, with little regard for whether its patients would actually benefit from the prescriptions he pushed,” said U.S. Attorney Erin Nealy Cox. “His greed tainted their care.”

The evidence presented at trial showed that Mr. Cooper, president and co-owner of pharmaceutical marketing group CMGRX, conspired with Richard Robert Cesario, CMGRX CEO and co-owner, to defraud TRICARE, the Defense Department’s health insurance program for military servicemembers and their families.

From September 2014 through May 2015, CMGRX caused over $124 million in claims to be billed to TRICARE, $70 million of which were paid.

Mr. Cooper and Mr. Cesario disguised these illegal kickbacks by claiming they were payments for participation in a bogus medical study and by funneling the money through the “Freedom from Pain Foundation,” a sham charity they funded, directed, and controlled.

The Defense Criminal Investigative Service and the Federal Bureau of Investigation’s Dallas Field Office conducted the investigation.

Mr. Cooper's sentencing marks a significant blow to the defendants, who will face further consequences in the coming months. Richard Robert Cesario, CMGRX CEO and co-owner, is awaiting sentencing after pleading guilty to conspiracy to commit health care fraud and receipt of illegal remuneration. CMGRX marketers Joe Straw and Luis Rios also pleaded guilty before trial and are likewise awaiting sentencing.

The case serves as a reminder of the importance of protecting the TRICARE program from fraudulent activities and the consequences of such actions.

Source: https://www.justice.gov/usao-ndtx/pr/health-care-executive-sentenced-20-years-tricare-fraud-case