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MyFloridaNews.com

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Jacksonville man pleads guilty to Medicare and Medicaid kickback scheme

JACKSONVILLE, Florida - Jonathan Simeon Gholston, a 35-year-old from Jacksonville, has pleaded guilty to conspiring to receive kickbacks for referring Medicare and Medicaid beneficiaries for HIV prophylactic medications. Gholston, who owned a marketing company, entered into an agreement with a Jacksonville pharmacy to market HIV post-exposure prophylactic medications, according to a press release from the U.S. Attorney's Office. The marketing company set up tents and tables in low-income areas, offering free government-sponsored cellphones in exchange for personal information, including health insurance details. Unbeknownst to the individuals, their information was used to generate prescriptions for HIV medications, which were then billed to Medicare and Medicaid. The pharmacy paid the marketing company $200 for each referred person, contingent on Medicare or Medicaid claim approval. The marketers received $50 per referral under the same condition. These payments were deemed illegal kickbacks under federal law. The scheme resulted in approximately 20,316 fraudulent claims, with Medicare and Medicaid reimbursing about $24,217,746 in total. Gholston personally received around $2,273,000, which he has agreed to forfeit to the government. The case was investigated by the U.S. Department of Health and Human Services – Office of Inspector General and the Federal Bureau of Investigation, and is being prosecuted