Healthcare is big business—and so is health care fraud. Just ask a Mississippi woman facing 15 years in prison after admitting to a complicated prescription drug fraud.
Follow the money is a game that works as well for the Internal Revenue Service (IRS) and health care tax fraud as it does for questionable offshore tax investments.
The Criminal Investigation (CI) unit of the IRS explores and prosecutes tax crimes like tax evasion, tax fraud, and money laundering that is conducted against agencies, governments, and sometimes healthcare companies. Among other types of healthcare fraud, some criminal schemes include:
- Pharmaceutical diversion
- Patient kickback schemes
- Nursing home or healthcare provider fraud
- Staged accidents and false physical, mental, and equipment claims to insurance companies
- False or inflated billings
So what about the Mississippi woman?
Hope Thomley is just one of a group of conspirators who admitted to bilking healthcare programs, including TRICARE, the healthcare program that serves members of the US military and their families. Ms. Thomley, a 52-year old Lamar County resident, was charged with 23 counts of tax crime while her husband, Randy Thomley, faced 26 criminal tax charges. An additional nine defendants pled guilty to the charges against them, and one other was convicted.
With that many defendants, the scheme had to be pretty big—and it was. The couple owned a marketing agency that associated with a compounding pharmacy, Advantage Pharmacy. Compounding pharmacies create specially formulated pharmaceutical products for individuals and healthcare providers.
In this exercise, the marketing agency received a 50 percent kickback on all prescriptions they obtained for Advantage Pharmacy. Business was so good that the crew of conspirators took to recruiting TRICARE patients, as well as writing and obtaining fake prescriptions to obtain inflated drug reimbursement from TRICARE.
Ms. Thomley admitted to conspiracy to commit health care fraud, money laundering, and tax evasion. Noted Assistant Attorney General Benczkowski, “Hope Thomley and her co-conspirators stole millions of dollars from a federal health care program that serves our nation’s brave military personnel and their families.” Overall, the scheme bilked healthcare providers out of $200 million.
Big business attracts big crime—and penalties. Ms. Thomley and her husband have seen seizure of $15 million in assets, and could see more than a decade in prison, along with fines, restitution, and probation.
Before they hit the big time, the Thomley’s had a different business, a family Christmas tree farm. Founded in 1967, the farm passed down to Randy Thomley. Chances are pretty good he will miss the Christmas tree season this year.
Knowledgeable advice from experienced tax attorneys in Chicago
At Robert J. Fedor, Esq., LLC we provide confidential, strategic options on tax litigation and other tax challenges. Whether you have concerns about an IRS audit, or you suspect a criminal tax investigation is in the offing, we can help. Contact us or call 800-579-0997 today.