GREENEVILLE, Tenn. (WJHL) — A federal judge in Greeneville sentenced multiple people and corporate entities in May for their involvement in a multimillion-dollar pharmacy fraud scheme.
A release from the U.S. Department of Justice (DOJ) revealed that seven people received sentences for the fraudulent operation, which persisted from May 2015 through April 2018.
Court documents identified Peter Bolos and his co-conspirators Michael Palso, Andrew Assad, Scott Roix, Larry Smith, Mihir Taneja, Arun Kapoor and Maikel Bolos along with multiple companies owned or controlled by those involved in the scheme.
The co-conspirators arranged that private insurers like Blue Cross Blue Shield of Tennessee as well as public insurers such as Medicaid and TRICARE paid money to pharmacies based on fraudulent claims — amounting to millions of dollars.
According to the DOJ release, Peter Bolos, Assad and Palso owned and operated Synergy Pharmacy in Palm Harbor, Florida, resulting in the hiring of telemarketer Roix to operate under the name HealthRight. The trio hired Roix to generate prescriptions for the pharmacy company using HealthRight’s platform as a telemedicine service.
“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,” the release stated.
The process, according to the DOJ, made the prescriptions invalid, resulting in the drugs being misbranded. However, Synergy and the other pharmacies operated by the co-conspirators continued to distribute the drugs to consumers so Peter Bolos could submit fraudulent reimbursement claims.
Smith created the following companies, which no longer operate, to help carry out the conspiracy: Alpha Omega Pharmacy, Germaine Pharmacy, Zoetic Pharmacy, ULD Wholesale LLC and Tanith Enterprises.
Evidence at the trial asserted that Peter Bolos, Palso and Assad paid the fraudulent telemarketer (Roix) millions to purchase at least 60,000 invalid prescriptions generated by HealthRight, with Bolos picking certain prescriptions to later use for profitable reimbursements, according to the DOJ.
A federal jury convicted Peter Bolos in December 2021, and on May 16, he received a 14-year prison sentence and $2.5 million in forfeiture. The court sentenced Palso to 33 months in prison on the same day. Both were each ordered to pay nearly $25 million in restitution.
The next day, on May 17, Smith received a 42-month prison sentence, and all the corporate entities he created were ordered to pay nearly $25 million in restitution. Taneja, who pleaded guilty to felony misbranding, received a 10-month prison sentence and a $10,000 fine.
Taneja was accused of co-creating a fraudulent business, identified as Sterling Knight, with Kapoor. On May 18, Kapoor received three years of probation and a $10,000 fine. The no-longer-operating Sterling Knight must pay $21 million in restitution. That same day, Maikel Bolos received a 15-month prison along with a $25,000 fine.
Assad, who had owned and operated Synergy Pharmacy with Bolos and Palso, received a 24-year prison sentence on May 19. He was also ordered to pay nearly $25 million in restitution. HealthRight was also sentenced to pay $4.25 million in restitution.
Roix awaits his sentencing, which was rescheduled for June 15.
“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. “The financial harm caused by health care fraud hurts all Americans, and the United States Attorney’s Office for the Eastern District of Tennessee will continue to support the cooperation among its federal law enforcement partners that is necessary to bring criminal swindlers like these defendants to justice.”
The following agencies helped conduct the multi-year investigation that led to the arrests and sentencings: HHS-OIG (Nashville), FDA-OCI (Nashville), U.S. Postal Service, Office of Inspector General (Buffalo), FBI (Knoxville and Johnson City), OPM-OIG (Atlanta) and HSA (Tampa).
The U.S. Marshals Service also helped in the investigation and the forfeiture of assets, the release noted.