Louisiana Marketer Sent To Prison In $180M+ Health Care Fraud - Insurance News | InsuranceNewsNet

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December 2, 2021 Top Stories
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Louisiana Marketer Sent To Prison In $180M+ Health Care Fraud

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A Louisiana marketer was sentenced today to 30 months in prison in the Southern District of Mississippi for his role in a multimillion-dollar scheme to defraud TRICARE and private insurance companies by paying kickbacks to distributors for the referral of medically unnecessary prescriptions.

TRICARE is the health care program for uniformed service members, retirees and their families. The conduct resulted in more than $180 million in fraudulent billings, including more than $50 million paid by federal health care programs.

According to court documents, Thomas "Tommy" Wilburn Shoemaker, 57, of Rayville, participated in a scheme to defraud TRICARE and other health care benefit programs by acting as a marketer for a network of pharmacies owned and operated by co-conspirators Mitchell "Chad" Barrett and David Jason Rutland.

Shoemaker worked with the pharmacies to use his TRICARE insurance to adjust prescription formulas to ensure the highest reimbursement without regard to efficacy, and he recruited doctors to procure prescriptions for high margin compounded medications. Shoemaker also obtained numerous fraudulent prescriptions using the personal information of military acquaintances.

Shoemaker pleaded guilty on Aug. 12 to conspiracy to defraud the United States and solicit, receive, offer, and pay illegal kickbacks. In addition to the term of imprisonment, Shoemaker was ordered to pay restitution and forfeit all assets traced to his ill-gotten gains.

Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department's Criminal Division; U.S. Attorney Darren J. LaMarca for the Southern District of Mississippi; Acting Assistant Director Jay Greenberg of the FBI's Criminal Investigative Division; and Special Agent in Charge Cyndy Bruce of the Department of Defense Office of Inspector General's Defense Criminal Investigative Service (DoD OIG-DCIS) Southeast Field Office made the announcement.

The FBI Jackson Field Office and DoD OIG-DCIS are investigating the case.

Trial Attorneys Emily Cohen and Alejandra Arias of the Criminal Division's Money Laundering and Asset Recovery Section and Assistant U.S. Attorney Kathlyn Van Buskirk of the Southern District of Mississippi are prosecuting the case with assistance from Sara Porter and Dustin Davis from the Criminal Division's Fraud Section.

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