In a significant legal development, Brad Duke, the mastermind behind a $10 million TRICARE scheme, has been sentenced to 36 months’ imprisonment and ordered to forfeit over a million dollars. Duke orchestrated the operation by promoting and generating prescriptions for compounded drugs, such as pain creams and scar creams, through a Mississippi-based compounding pharmacy. As TRICARE, the health insurer for the military, paid substantial amounts per patient for these drugs, Duke engaged in illegal activities by paying kickbacks to recruiters to find TRICARE beneficiaries willing to receive the drugs. Duke’s scheme resulted in over $10 million in compound drug prescriptions and involved the participation of multiple accomplices. The investigation was carried out by the FBI and the U.S. Department of Health and Human Services, Office of the Inspector General.
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Background
Overview of the TRICARE Scheme
TRICARE is the national military’s health insurer. It provides medical benefits to active duty service members, retirees, and their families. The scheme covers a wide range of health services, including prescription medications.
Main Participants in the Scheme
The main participants in the TRICARE scheme are the beneficiaries, the doctors who prescribe medications, the pharmacies that fill the prescriptions, and the insurance providers who reimburse the costs.
Investigation and Prosecution
A multi-million dollar kickback conspiracy within the TRICARE scheme was recently discovered and investigated. The scheme involved fraudulent prescriptions, illegal payments, and conspiracy to defraud the government. The investigation led to the identification of several individuals involved in the scheme, including the ringleader, Brad Duke.
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The Sentencing
Length of Sentence
Brad Duke, the ringleader of the TRICARE scheme, was sentenced to 36 months’ imprisonment. This means that he will serve a prison term of three years. The length of the sentence reflects the seriousness of the crimes committed and serves as a deterrent for others who may consider engaging in similar illegal activities.
Forfeiture of Funds
In addition to the prison sentence, Brad Duke was also ordered to forfeit $1,055,855.86. The forfeiture of funds is a common practice in cases involving financial crimes. It serves as a way to punish the perpetrator and deter others from engaging in similar illegal activities. The forfeited funds will be returned to the government and used to support programs and services for the beneficiaries of the TRICARE scheme.
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Brad Duke’s Role
Promotion of Prescription Drugs
Brad Duke played a key role in the TRICARE scheme by promoting prescription pain creams, scar creams, and supplements for a compounding pharmacy. He earned a share of the payments made by TRICARE for the prescriptions issued by his affiliated doctors.
Discovery of TRICARE Payments
After learning that TRICARE paid significant amounts per month per patient for the compounded drugs he was promoting, Brad Duke began offering and paying kickbacks to generate prescriptions for those with TRICARE insurance. This discovery was a turning point in the investigation, as it revealed the motive behind Duke’s actions and the extent of the fraudulent scheme.
Kickbacks to Recruiters
To expand the reach of the scheme and generate more prescriptions, Brad Duke paid kickbacks to recruiters. These recruiters included Michael “Chance” Beeman, Michael Sean Brady, Jason Greene, Brian Means, and Jennifer Sorenson. They were responsible for finding TRICARE beneficiaries willing to receive the drugs and providing Duke with their insurance information.
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Recruiters and Medical Assistant
Michael ‘Chance’ Beeman
Michael ‘Chance’ Beeman was one of the recruiters in the TRICARE scheme. He was responsible for finding TRICARE beneficiaries across the country who would be willing to receive the drugs promoted by Brad Duke. Beeman played a crucial role in the recruitment process and received payments from Duke for his services.
Michael Sean Brady
Michael Sean Brady was another recruiter involved in the TRICARE scheme. Like Beeman, he helped identify TRICARE beneficiaries and provided their insurance information to Brad Duke. Brady received payments for his role in the scheme.
Jason Greene
Jason Greene, another participant in the TRICARE scheme, was responsible for recruiting TRICARE beneficiaries and providing their insurance information to Brad Duke. Greene played a key role in expanding the reach of the scheme and received payments for his involvement.
Brian Means
Brian Means, like the other recruiters, helped Brad Duke identify TRICARE beneficiaries and provided their insurance information. Means was an instrumental figure in the scheme and received payments for his services.
Jennifer Sorenson
Jennifer Sorenson was one of the recruiters involved in the TRICARE scheme. She played a role in finding TRICARE beneficiaries and providing their insurance information to Brad Duke. Sorenson received payments for her involvement in the scheme.
Charlotte Leija
Charlotte Leija, a medical assistant, played a crucial role in the TRICARE scheme. Upon receiving beneficiary information from the recruiters, Brad Duke would route prescriptions in the names of the TRICARE beneficiaries to Leija. She would file the prescriptions under the name of the doctor for whom she worked. Leija received kickbacks from Duke for her services.
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Operation of the Scheme
Filing Prescriptions under Doctor’s Name
One of the key tactics used in the TRICARE scheme was the filing of prescriptions under the name of a doctor without their knowledge or consultation. Brad Duke would obtain the necessary prescription information from TRICARE beneficiaries, and Charlotte Leija, the medical assistant, would file the prescriptions under the name of the doctor she worked for. This allowed the scheme to operate without the involvement or knowledge of the prescriber.
Number of Beneficiaries and Prescription Amounts
Over the course of a year, Brad Duke’s scheme generated over $10 million in compound drug prescriptions for over 100 TRICARE beneficiaries. The scheme targeted beneficiaries across the country, from California to Massachusetts. The scheme exploited the high reimbursements provided by TRICARE for compounded drugs and manipulated the prescription process to generate large amounts of money.
Absence of Prescriber Consultation
One of the most troubling aspects of the TRICARE scheme was the absence of prescriber consultation. None of the TRICARE beneficiaries who received the compounded drugs had any consultation with the prescribing doctors. The prescriptions were filed under the doctor’s name without their knowledge, and the beneficiaries received the drugs without any medical oversight. This lack of proper medical care put the health and well-being of the beneficiaries at risk.
Sentencing of Co-Conspirators
Prison Terms
In addition to Brad Duke, the ringleader of the TRICARE scheme, several co-conspirators were sentenced for their involvement. Michael Sean Brady, Michael “Chance” Beeman, Jason Greene, Brian Means, Jennifer Sorenson, and Charlotte Leija all received prison terms ranging from 8 months to 28 months. The varying lengths of the prison terms reflect the level of involvement and responsibility of each co-conspirator in the scheme.
Forfeiture of Proceeds
In addition to the prison terms, the co-conspirators were also ordered to forfeit the illicit proceeds they gained from the TRICARE scheme. The amounts forfeited ranged from $198,799 to $598,435.99. The forfeiture of proceeds serves to remove the financial gains obtained through illegal activities and ensures that the perpetrators are held accountable for their actions.
Seizure of Funds
Amount Seized by U.S. Marshals
As of the sentencing hearing, the U.S. Marshals had already seized $1,055,855.86 from Brad Duke. This amount represents the funds that Duke acquired through his involvement in the TRICARE scheme. The seizure of funds is an important step in the process of recovering financial losses incurred as a result of illegal activities. The seized funds will be returned to the government and used to support programs and services for the beneficiaries of the TRICARE scheme.
Investigative Agencies
FBI
The FBI played a crucial role in the investigation of the TRICARE scheme. They worked alongside other law enforcement agencies to uncover the extent of the fraud and gather evidence against the perpetrators. Their expertise in financial crimes and their dedication to protecting the interests of the beneficiaries of the TRICARE scheme were instrumental in bringing those responsible for the scheme to justice.
U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG)
The U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG), also played a significant role in the investigation of the TRICARE scheme. Their expertise in healthcare fraud and their commitment to ensuring the integrity of government healthcare programs were essential in uncovering the illegal activities and supporting the prosecution of the perpetrators. The partnership between the FBI and the HHS-OIG demonstrates the importance of collaboration between law enforcement agencies and government departments in combating healthcare fraud.
Prosecution
Assistant United States Attorney Alexander D. Morgan
Assistant United States Attorney Alexander D. Morgan played a crucial role in the prosecution of the TRICARE scheme case. He worked tirelessly to build a strong case against Brad Duke and the other co-conspirators, presenting the evidence and arguments in court. His dedication to upholding the law and seeking justice for the victims of the scheme was instrumental in securing the convictions and sentences of the defendants.
Conclusion
The sentencing of Brad Duke and his co-conspirators is a significant step in addressing the multi-million dollar TRICARE scheme that defrauded the government and put the health and well-being of beneficiaries at risk. The investigation, led by the FBI and the HHS-OIG, uncovered the extent of the scheme and brought those responsible to justice. The prison terms, forfeiture of funds, and seizure of assets serve as a deterrent to others who may consider engaging in similar fraudulent activities within the TRICARE scheme. The successful prosecution, led by Assistant United States Attorney Alexander D. Morgan, sends a clear message that healthcare fraud will not be tolerated and that those who exploit government healthcare programs will be held accountable for their actions. The sentencing of the defendants and the recovery of funds are important steps in ensuring the integrity and sustainability of the TRICARE scheme, and in protecting the well-being of the beneficiaries it serves.
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