Serge Francois, Health Care Fraud, Florida 2018

Grimy Times Exclusive

In a shocking case of health care fraud, Serge Francois, a 52-year-old pharmacist from Southwest Ranches, Florida, has been sentenced to 204 months in prison for his involvement in a $30 million health care fraud scheme against the Tricare program. Francois’s accomplice, Patrick Tonge, 42, of Southwest Ranches, received a 188-month prison sentence. Both men were ordered to pay $31,259,252 in restitution.

The case, which was the largest health care fraud case involving the Tricare program to go to trial, began with a three-year investigation. The scheme, which caused over $31 million in loss to the federal Tricare program and the Federal Employee Health Benefit Program, involved Francois and Tonge conspiring with so-called marketers who paid physicians to write prescriptions for expensive topical medications that cost up to $17,000 a bottle.

According to the evidence presented at trial, Francois, the pharmacist-in-charge at Atlantic Pharmacy and Compounding, was responsible for the compounded medications, which were made in-house by the pharmacy. Francois and Tonge would automatically refill the prescriptions, sending numerous refills to patients who did not request them and not charging a co-pay. The marketers would then pay the physicians, while Francois and Tonge would pay the marketers from the profits received for each prescription.

The investigation, which resulted in 18 convictions, revealed that some physicians never saw the purported patients. Instead, they used the patient’s identification to write the prescriptions. This brazen scheme highlights the need for increased vigilance in the health care industry to prevent such massive frauds.

U.S. District Judge Darren P. Gayles handed down the sentences on March 9, 2018. The case was a culmination of a one-month trial, which found Francois guilty of 12 counts of health care fraud, conspiracy to pay kickbacks, and 12 counts of money laundering, among other charges. Francois was also found guilty of 8 counts of introducing misbranded drugs into interstate commerce. Tonge was found guilty of 11 counts of health care fraud and 3 counts of paying kickbacks.

The Tricare program, which provides health care to military service members, veterans, and their families, has been a frequent target of health care fraud schemes. This case serves as a reminder of the need for increased scrutiny and oversight to prevent such massive frauds from occurring in the future.

Grimy Times will continue to follow this case and provide updates as more information becomes available.

Related Federal Cases