2 Individuals Charged in $31-Million Health Care Fraud Scheme

NOVEMBER 08, 2016
Jennifer Barrett, Assistant Editor

Two individuals were charged in a $31-million health care fraud scheme that ran throughout Florida.
 
The defendants, Serge Francois and Patrick Tonge, allegedly took part in the scheme to defraud TRICARE and the Federal Employees Health Benefit Program (FEHBP) through kickbacks and money laundering. They were charged along with 2 other co-conspirators, Celep Simsir and Sonsoles Simir.
 
Francois and Tonge allegedly offered and paid kickbacks and bribes to patient recruiters in return for referring TRICARE beneficiaries to Atlantic Pharmacy, where Francois was the owner and Tonge was an employee. Atlantic would then allegedly compound medications and mail them to the recruited TRICARE beneficiaries. The co-conspirators are accused of submitting false and fraudulent prescriptions that were not medically necessary.
 
Additionally, Francois also falsely stated that none of the Atlantic pharmacists had been disciplined by the US Drug Enforcement Administration (DEA). Francois had actually owned a pharmacy that the DEA suspended in 2004.
 
The defendants allegedly submitted $37 million in false and fraudulent claims to TRICARE and FEHBP through Atlantic. The pharmacy received about $31 million as a result of the fraudulent claims.
 
The scheme ran from April 2010 through May 2015 in Miami-Dade and Broward counties, as well as throughout the Southern District of Florida.
 
If convicted, Francois and Tonge may be forced to forfeit up to $31 million and any property derived from the scheme.
 

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