A former Air Force officer has been sentenced to two years behind bars for her role in a nationwide scheme to defraud the military's health program, Tricare, of billions of dollars.
Maj. Romeatrius Moss, 40, pleaded guilty Oct. 15, 2019, to accepting kickbacks for referring patients at Vance Air Force Base, Oklahoma, to civilian pharmacies that specialized in compounded medications; she faced up to five years in prison.
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Moss admitted to giving service members and other patients at the base medical clinic pre-printed prescription pads and encouraging them to ask their doctors for specialty medications -- compounded personalized prescriptions for pain and other ailments.
She then sent the prescriptions to specific pharmacies and received a portion of the Tricare reimbursement paid to the pharmacies for those scripts.
Moss was sentenced Monday to 24 months in prison and three years of supervised release; she was also ordered to pay $622,459 -- the amount she made in the scheme -- in restitution, according to the Justice Department.
As part of her plea agreement, she also must give up her $750,000 house in Enid, Oklahoma; a 2016 Porsche Cayenne; and a 2000 Fleetwood Pace Arrow recreational vehicle.
From 2012 to 2015, some pharmacy companies that craft compounded medications -- custom doses or formulas of drugs for patients who can't tolerate ingredients in standard medications -- discovered a loophole in the federal government's rules on such prescriptions and capitalized on it.
They began marketing the medications directly to those enrolled in Tricare, encouraging patients to try their compounded pain and scar creams, wound ointments and erectile dysfunction drugs, which they then billed to the federal government, at a cost of $400 to $10,000 per prescription.
After the Government Accountability Office in 2014 warned the Defense Department to improve its oversight and policies on compounded medications, the Defense Health Agency moved to limit coverage of them in early 2015. By then, however, it had paid out nearly $2 billion to these pharmacies.
Moss is one of the highest-ranking service members to be convicted in the fraud scheme to date. She earned a doctorate in nursing practice from the University of Alabama-Birmingham and is the founder of Black Nurses Rock, a foundation that supports African-American nurses. Moss also ran a consulting and career coaching business while serving in the Air Force.
On Monday, the Justice Department announced that a health care executive in northern Texas has been sentenced to 20 years for his role in the scheme. A jury found John Paul Cooper, 56, guilty of conspiracy to commit heath care fraud and receipt and payment of kickbacks.
Cooper and the co-owner of pharmaceutical marketing group CMGRX, Richard Cesario, recruited more than 2,300 patients -- many of them service members or families stationed at Fort Hood, Texas -- to order compounded pain and scar creams.
In return, the military personnel received $250 per prescription -- a kickback Cooper and Cesario said was payment for their participation in a bogus medical study or a charitable donation from their fake charity, the "Freedom from Pain Foundation."
According to the Justice Department, Cooper and Cesario also paid doctors to write prescriptions for patients following phone calls. As a result of their fraud, more than $124 million in pharmacy claims were filed with Tricare.
"This defendant siphoned millions of dollars from the Defense Department's health insurance program, with little regard for whether its patients would actually benefit from the prescriptions he pushed," U.S. Attorney Erin Nealy Cox said in a statement. "His greed tainted their care."
To date, Justice Department investigations into the fraud have resulted in the convictions of more than 100 people and recovered roughly $300 million.
-- Patricia Kime can be reached at Patricia.Kime@Monster.com. Follow her on Twitter @patriciakime.
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