Tampa Pharmacists Sentenced In Multimillion-Dollar Telemedicine Scheme

TAMPA, FL — A federal judge in Greeneville, Tennessee, has sentenced two Tampa men for their roles in a multimillion-dollar health care fraud scheme after years of investigation by federal agencies in several states.

Peter Bolos, 44, of Tampa, was convicted by a federal jury in December of conspiracy to commit health care fraud, 22 counts of mail fraud and introduction of a misbranded drug into interstate commerce.

U.S. District Judge J. Ronnie Greer sentenced Bolos to 14 years in prison and ordered him to pay more than $24.6 million in restitution and $2.5 million in forfeiture.

See related story: Pharmacy Owners Indicted In Billion-Dollar Health Care Scheme

The court also sentenced Bolos's co-defendant, Michael Palso, 48, of Tampa, to 33 months in prison and ordered him to pay more than $24.6 million in restitution. Palso previously pleaded guilty to his role in the conspiracy, as did 14 other defendants in related cases.

According to court documents and evidence presented at trial, Bolos, Palso and their co-conspirators, Andrew Assad, Scott Roix, Larry Smith, Mihir Taneja, Arun Kapoor and Maikel Bolos, as well as various other companies owned or controlled by some of these people, deceived pharmacy benefit managers (PBMs), such as Express Scripts and CVS Caremark, regarding tens of thousands of prescriptions.

The PBMs processed and approved claims for prescription drugs on behalf of insurance companies. Bolos and his co-conspirators defrauded the PBMs into authorizing millions of dollars' worth of claims that private insurers such as Blue Cross Blue Shield of Tennessee and public insurers such as Medicaid and TRICARE, paid to pharmacies controlled by the co-conspirators.

"The scale of the prescription-drug fraud scheme orchestrated by these defendants and their conspirators was astonishing, and the court's prison sentences reflect the seriousness of their crimes," said U.S. Attorney Francis M. Hamilton III for the Eastern District of Tennessee.

Court documents and evidence at trial established that Bolos, Assad and Palso owned and operated Synergy Pharmacy in Palm Harbor. Under their direction, Synergy employed Scott Roix, a Florida telemarketer operating under the name HealthRight, to generate prescriptions for Synergy and the other pharmacies involved in the scheme.

The prescriptions were typically for drugs such as pain creams, scar creams and vitamins. To obtain the prescriptions, Roix used HealthRight's telemarketing platform as a telemedicine service, cold-calling consumers and deceiving them into agreeing to accept the drugs and to provide their personal insurance information.

HealthRight then paid doctors to authorize the prescriptions through its telemedicine platform, even though the doctors never communicated directly with the patients and relied solely on the telemarketers' screening process as the basis for their authorizations.

Because this faulty and fraudulent process made the prescriptions invalid, the drugs were misbranded under the Food, Drug and Cosmetic Act. Synergy and the other pharmacies nonetheless dispensed the drugs to consumers as part of the scheme, so that Bolos could submit fraudulent reimbursement claims.

Court documents and evidence at trial established that during the conspiracy, which lasted from May 2015 through April 2018, Bolos and Palso, along with co-defendant Andrew Assad, paid Roix millions of dollars to buy at least 60,000 invalid prescriptions generated by HealthRight.
Bolos selected specific medications for the prescriptions that he could submit for profitable reimbursements at inflated prices. In addition, Bolos, Palso, and Assad used illegal means to hide his activity from the PBMs so that they could remain undetected.

"This sentencing is the result of a multi-agency investigation into a complex telemedicine pharmacy fraud scheme, requiring substantial investigative resources," said Special Agent in Charge Joseph E. Carrico of the FBI's Knoxville Field Office.

"Bolos and his co-conspirators abandoned their responsibilities in the health care industry through an elaborate fraud scheme and manipulated the system without regard for patient need or medical necessity to line their pockets," said Special Agent in Charge John Condon of Homeland Security Investigations Tampa. "This significant sentence should serve as a warning to anyone who attempts to deceive the government and steal from taxpayers."

Larry Smith, Alpha-Omega Pharmacy, Germaine Pharmacy, Zoetic Pharmacy, Tanith Enterprises LLC, ULD Wholesale Group and Taneja were sentenced on May 17.

Kapoor, Sterling Knight Pharmaceuticals and Maikel Bolos were sentenced on May 18.

Assad, Roix and HealthRight LLC were sentenced on May 19.

"Providers who solicit beneficiaries' personal information and use it to defraud federal health care programs not only undermine the integrity of those programs; they also divert valuable taxpayer dollars for self-serving purposes," said Special Agent in Charge Tamala E. Miles of the Department of Health and Human Services.