Florida scam reveals breadth of compound pharmaceutical billing

Eight Florida residents were charged last week with billing the federal government more than $633 million for compounded pharmaceuticals over a three-year period, according to the U.S. Attorney’s Office for the Middle District of Florida--events that underscore the intensity of emerging fraud concerns about compounded drugs.

A group of eight co-conspirators, led by Nicholas A. Borgesano—the president of five pharmacies and several medical billing companies in Tampa Bay and Miami—billed Medicare, Tricare and private insurance companies more than $633 million for compounded pharmaceutical prescriptions between October 2012 and December 2015, according to the indictment

The group was paid more than $157 million for illegitimate prescriptions that were often allegedly the result of elaborate kickbacks. In some instances, the group allegedly misrepresented some claims by billing for certain high-priced ingredients that were not included in the final compounded prescription.

As part of the arrest, authorities confiscated 17 properties, 15 luxury vehicles and several boats.

Earlier this year, federal and state authorities raided pharmacies in four states, including Florida, as part of a widespread bust involving compounding pharmacies. Federal officials have been targeting compounding pharmacies following a spike in high-priced Tricare claims. Investigators and legal experts have said the cases and investigations brought forward thus far are “just the beginning.”

- read the U.S. Attorney’s Office release

- here’s the indictment