The U.S. Government operates several healthcare insurance options for those in need, terminally ill, or who have served their nation as a member of the Armed Forces. The Tricare insurance scheme is operated under the leadership of the Department of Defense and provides compound pharmacy services for members of the military and veterans who require these options. A Tricare fraud problem can be difficult for any pharmacy owner to handle whether they are guilty or innocent of the charge because the Department of Defense is aggressively seeking to prosecute those it suspects of making fraudulent claims.
Tricare Compound Pharmacy Fraud
A Tricare compound pharmacy is a special location where medications are manufactured for a variety of reasons. The work being completed at compound pharmacies across the U.S. is so special that it takes place in less than 8,000 of the more than 50,000 pharmacies across the nation. There are a number of ways these Tricare compound pharmacies help those who are in the most need, including the development of drugs that may have been discontinued for many years for extremely rare medical cases. Compound pharmacy fraud makes it difficult for the authorities to keep track of the cost of the drugs being produced in these locations. There are many forms of compound pharmacy fraud that can take place with the most common being the overcharging for drugs that have been produced. Another common form of this fraud is the charging for drugs that were never produced.
Kickbacks to Doctors
Much like the majority of other forms of healthcare fraud, a large number of those who are affected by Tricare compound pharmacy fraud are involved is providing kickbacks to doctors and other medical professionals. Those who can provide referrals to a compound pharmacy include surgeons, chiropractors, and other pharmacists who cannot find the medications needed to assist their patients. Kickbacks for referrals are a common issue for the investigating agencies involved in bringing prosecutions for Tricare compound pharmacy fraud. There are many different groups who are involved in conducting an investigation into this form of fraud, including:
Understanding Tricare Pharmacy Fraud
One of the easiest ways of avoiding the problems associated with compound pharmacy fraud is to take the time to obtain a thorough understanding of the reasons why these investigations are brought against individuals and companies. The main concern for those who are under investigation for a federal felony is whether their actions broke the myriad of rules surrounding working with the Department of Defense. Because the Tricare program is administered by the Department of Defense it falls under the federal rules associated with working with these agencies.
Among the different rules associated with working with the Tricare program is the inability to incentivize these forms of the federal programs. Among the issues that should be considered when looking to avoid an investigation in Tricare fraud is the problem of any business development payments made to 1099 contractors remaining illegal. Other issues include the use of percentage-based remuneration for those taking part in federal programs which can lead to the individual taking part in a program being charged with a felony resulting in federal jail time.
What Charges can be Brought
There is a range of charges that can be brought against those who are investigated for any federal Tricare compound pharmacy fraud includes the conspiracy charges that are commonly brought against those under federal investigation. Conspiracy to commit healthcare fraud charges is an option often taken by the Federal prosecutor of any case when there are two or more defendants involved in the case.
Penalties for Tricare Fraud
Depending on the type of charges brought against an individual from conspiracy to the completion of healthcare fraud, the issue of how much jail time will be obtained is vital information for any defendant. This kind of fraud can result in jail time of between zero and 20 years depending on the severity of the crimes committed.
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