Tulsa U.S. Attorney: Three Docs, Five Marketers Charged In Health Insurance Scam

TULSA, Oklahoma, June 13 -- The U.S. Attorney for the Northern District of Oklahoma, Trent Shores, issued the following news release:

Three physicians and five marketers have been charged in U.S. District Court with violations of the federal anti-kickback statute and other criminal offenses, announced U.S. Attorney Trent Shores. The men allegedly caused federal health care insurance programs to pay reimbursement costs for fraudulent and expensive compounding drug prescriptions written by recruited doctors in return for kickback payments. The defendants would then use the reimbursed funds for their own financial gain.

"Sadly, the American taxpayer ends up paying the price when unscrupulous medical professionals fraudulently bill federal health insurance. In these cases, patients believed they were receiving a compounded cream that fit their specific medical need. In actuality, the charges allege that the drug mixtures prescribed and received by the patients were designed to line the pockets of criminally corrupt doctors with illegally begotten funds," said U.S. Attorney Shores. "Every dollar we recover from those who defraud federal health insurance programs will be a dollar that goes back to providing healthcare for Americans served by these programs."

Dr. Krishna Balarma Parchuri, 44, of Tulsa, is charged in a superseding Indictment along with Christopher R. Parks, 57, of Tulsa, Dr. Gary Robert Lee, 58, of Tulsa, and Dr. Jerry May Keepers, 65, of Kingwood, Texas, with conspiracy to commit health care fraud. Keepers and Parchuri are also charged with soliciting and receiving illegal bribes and kickback payments. Parchuri is further charged with obstructing the criminal investigation into the health care offenses.

The criminal indictment alleges that since November 2012, Parks and Lee, engaged in a conspiracy to unlawfully pay kickbacks and bribes to physicians in order to induce the physicians to write expensive compounding prescriptions to pharmacies they controlled, including OK Compounding LLC, in Skiatook, One Stop RX LLC in Tulsa and NBJ Pharmacy LLC and Airport McKay Pharmacy, both in Houston. The defendants then allegedly submitted large claims for payment to federal health care programs and divided the profits. The defendants are accused of causing Tricare to pay reimbursement for false claims in the total amount of $3,207, 514.97; Medicare in total of $285,776.87; FECA Program in total of $552,544.55; and CHAMPVA in total of $310,273.64.

Compounding prescriptions is a practice in which a pharmacist or physician combines ingredients of multiple drugs to create a medication that is tailored to the specific needs of a patient. These medications are prescribed when standard Food and Drug Administration (FDA) approved drugs are unsuitable for the patient. They are also more expensive and reimbursed at a far higher rate by federal and private insurance companies. Compounded drugs are not to be mixed or marketed in bulk.

The charges allege that, in some cases, physicians were provided pre-printed prescription pads that listed compounding formula choices. Participating physicians allegedly checked a box with their preferred selection and then faxed it directly to the associated pharmacies, rather than writing a prescription tailored to the patient who could then take it to a pharmacy of their choice.

Parchuri, an orthopedic surgeon practicing in Tulsa, Oklahoma, and a doctor of osteopathic medicine licensed in Arizona, Kansas, Oklahoma, Florida, and Texas, received kickbacks and bribes in varying amounts up to $50,000 per month from Parks and Lee in exchange for writing compounded drug prescriptions that were submitted to pharmacies controlled by the two men.

Keepers allegedly solicited and received more than $860,000 in illegal bribe and kickback payments from Parks and Lee.

According to the indictment, kickback payments were disguised through various sham business arrangements, including contracts where physicians purported to serve as "medical directors" or "consulting physicians" for the pharmacies. Doctors were also recruited as "medical directors" for a university study. In actuality, the sham arrangements were meant to conceal the fact doctors were receiving kickback payments for writing prescriptions. Additionally, limited liability companies ("LLCs") were created, owned and operated by the corrupt pharmacies/marketers and physicians who submitted the compounding prescriptions. After the pharmacies received payments for the illegal prescriptions, the conspirators transferred the profits to the LLCs to be divided among the conspirators.

Jonathon Yates Boyd III, 47, of Sugarland, Texas, is charged in an Information for conspiring to pay health care kickbacks. In 2012, Boyd formed R&A Marketing LLC, in Houston, Texas, and began recruiting physicians to write prescriptions for compounded drugs. From November 2012 to September 2014, Boyd conspired to pay kickbacks and bribes to physicians to induce them to write prescriptions for expensive compounded drugs and to submit those prescriptions to pharmacies controlled and operated by Parks and Lee. The conspirators then submitted large claims for payment to various federal health care programs and divided the profits from the federally-paid claims. Boyd was paid a commission based upon the reimbursed prescriptions.

The kickback payments were allegedly disguised through fraudulent business arrangements. Contracts were created between the corrupt pharmacies and physicians for services as "medical directors" or "consulting physicians" to the pharmacies. In actuality, the doctors did not provide the services. The sham arrangements were meant to conceal the fact doctors were receiving kickback payments for writing prescriptions. R&A Marketing and the pharmacies were each responsible for their prearranged portion of the kickback payments.

Daniel Richard Ferguson, 47, of Broken Arrow; John Richard Frohrip, 52, of Tulsa; and Kevin Ellis Partin, 49, of Bixby are charged in three separate Informations with offering or paying health care kickbacks. On March 30, 2015, the men allegedly paid a physician a $15,000 check payment from an account controlled by Brookhaven Specialty Pharmacy, LLC, which constituted a kickback in return for the physician referring patients to Brookhaven for compounding prescriptions that would be reimbursed by the federal health care program Tricare.

Conspiracy to violate the anti-kickback statute carries a possible maximum sentence of five years in prison and a $250,000 fine, while violating the anti-kickback statute carries up to 10 years in prison and a $100,000 possible fine. A conviction of health care fraud without injury or death also carries a possible maximum of 10 years in prison, but if resulting in injury or death, the maximum penalty climbs to 20 years or life in prison, respectively.

Assistant U.S. Attorneys Melody N. Nelson and Richard M. Cella are prosecuting the cases. The Department of Labor- Office of Inspector General (OIG), IRS - Criminal Investigation, U.S. Postal Service- OIG, Department of Veterans Affairs- OIG, FBI, the Department of Health and Human Services-OIG, and Defense Criminal Investigative Service conducted the investigation.