Ohio Man Arrested For Orchestrating $10M Dollar Scheme To Defraud Health Care Benefit Programs
NEWARK, N.J. – An Ohio man was arrested today for his role in a large-scale, multi-level marketing scheme to defraud private and federally funded health care benefit programs of at least $10 million through the submission of claims for medically unnecessary prescriptions for compounded medications, U.S. Attorney Craig Carpenito announced.
Kent Courtheyn, 35, of Kent, Ohio, owner and operator of two companies involved in the sales and marketing of compounded medications, IntegriMed Solutions LLC (IntegriMed) and KA Compounding LLC (KA Compounding), was charged by a federal grand jury in a two-count indictment with conspiring to commit health care fraud and conspiring to violate the Anti-Kickback Statute. He is scheduled to have his initial court appearance today in federal court in Ohio.
According to documents filed in this case and statements made in court:
From as early as July 2014 through July 2016, Courtheyn, a former medical device sales representative, ran a scheme to defraud federally funded health care benefit programs, such as TRICARE, as well as privately funded health care benefit programs. TRICARE is a health care entitlement program of the U.S. Department of Defense (DoD) Military Health System that provides coverage for DoD beneficiaries worldwide, including active duty service members, National Guard and Reserve members, retirees, their families, and survivors.
Courtheyn recruited individuals to submit false and fraudulent claims for medically unnecessary compounded medications, such as pain creams, scar creams, wound creams, and metabolic vitamins, without regard to medical necessity. Compounding is a practice in which a licensed pharmacist or physician combines, mixes or alters ingredients of a drug to create a medication tailored to the needs of an individual patient. Pharmacies engaging in the practice are referred to as “compounding pharmacies.” Generally, compounded medications are not approved by the Food and Drug Administration (FDA), but can be prescribed by a physician when an FDA-approved drug does not meet the health needs of a particular patient. Compounded medications are supposed to be tailored to a patient’s particular medical need.
Read more: https://www.justice.gov/usao-nj/pr/ohio-man-arrested-orchestrating-10-million-dollar-scheme-defraud-health-care-benefit