Former South Florida Pharmacy VP and Executive Assistant Sentenced for Their Roles in Health Care Fraud Scheme Targeting U.S. Military
(STL.News) A former South Florida pharmacy executive was sentenced today to seven and a half years in prison for defrauding Tricare and CHAMPVA of approximately $88 million through a compounding pharmacy fraud scheme. His executive assistant received a sentence of five years imprisonment for her role in the conspiracy.
Juan Antonio Gonzalez, U.S. Attorney for the Southern District of Florida; Cynthia A. Bruce, Special Agent in Charge, Southeast Field Office of the Defense Criminal Investigative Service (DCIS); Robert DeWitt, Acting Special Agent in Charge, FBI Miami; David Spiker, Special Agent in Charge, U.S. Department of Veterans Affairs, Office of Inspector General (VA-OIG); and Justin Fielder, Special Agent in Charge, U.S. Food and Drug Administration, Office of Criminal Investigations (FDA-OCI) made the announcement.
Matthew Smith, 58, of Boca Raton, Florida, pleaded guilty on January 24, 2022, to one count of conspiracy to commit health care fraud. His executive assistant, Alisa Catoggio, 41, also of Boca Raton, Florida, pleaded guilty on May 17, 2022, to one count of conspiring to pay healthcare kickbacks.
In connection with the plea, Smith admitted his role submitting fraudulent claims to Tricare and CHAMPVA for expensive, medically unnecessary compound drugs through a Broward pharmacy. Tricare and CHAMPVA are the health care benefit programs for the United States Department of Defense and Department of Veterans Affairs.
In furtherance of the scheme, Smith paid kickbacks to patient recruiters in exchange for their recruiting beneficiaries and referring prescriptions for the medical unnecessary drugs. For her role, Catoggio calculated and tracked the kickbacks and sham co-pay assistance programs used to further the scheme. The fraudulent referrals caused an actual loss to the government programs of approximately $88 million.
In addition to the prison sentence, the Court imposed restitution in the amount of $75,106,971.
DCIS, FBI Miami, VA-OIG, and FDA-OCI investigated the case. Assistant U.S. Attorney Jon Juenger prosecuted the case. Assistant U.S. Attorney Daren Grove is handling the asset forfeiture component of the case.