A Trussville man was sentenced to more than four years in federal prison for his role in a multi-million-dollar health care fraud and kickback conspiracy case, prosecutors announced Wednesday.
Along with a 56-month prison sentence, John Alan Robson, 41, was ordered to forfeit $1.1 million and pay $5.3 million in restitution.
“This was a crime of greed and indifference to the consequences of the actions to the overall health system,” said U.S. Attorney Prim Escalona in a statement. “The crime cost insurers millions of dollars, and it exploited vulnerable patients trying to get appropriate medical care, not run up the tab on insurance. We will continue to fight hard to keep our community safe from serious crimes like this one.”
U.S. District Court Judge L. Scott Coogler sentenced Robson earlier this week. He was indicted in February and pleaded guilty to health care fraud conspiracy.
According to Robson’s plea agreement, he knew insurers would not pay for items or services that had been ordered based on kickbacks or that were medically unnecessary for a patient.
Yet hereceived kickbacks— from specialty pharmacies, a nerve conduction testing company, and brace suppliers— to generate medically unnecessary orders and prescriptions from doctors’ offices that would be billed to insurance and reimbursed at high rates, prosecutors said.
Robson marketed nerve conduction testing to medical providers for a Huntsville-based company called QBR or Diagnostic Referral Community. QBR paid those providers a flat fee for each test they ordered that insurance paid for. QBR paid Robson a flat fee for each of those tests as well.
QBR paid one of Robson’s medical practices more than $100,000 in per-test kickbacks, prosecutors said.
Robson also marketed high-reimbursing topical creams—such as pain creams and scar creams—to providers on behalf of specialty pharmacies like Global Compounding Pharmacy and Watson Rx Solutions.
Robson was paid lucrative commissions on the cream prescriptions that he and his team generated and insurance paid for. Robson got prescriptions for himself and family members regardless of whether those topical creams were medically necessary for the patients. Robson and other sales reps got blank, pre-signed prescriptions from medical providers, filled out the prescriptions to make sure insurance would pay for them, and even selected the drugs or drug formulations to make sure insurance would pay for them, prosecutors said.
As part of his plea deal, Robson admitted that federal insurance programs paid millions of dollars for medically unnecessary prescriptions for which Robson, Ray, and Bowman received commissions.
“Health care fraud is not a victimless crime. It costs U.S. taxpayers millions of dollars every year. It can raise health insurance premiums, expose patients to unnecessary medical procedures, and increase taxes,” said James DeLoatch, acting special agent in charge of the FBI’s Birmingham Division, in a statement. “The FBI is committed to coordinating with our partners and aggressively pursuing those who take advantage of others for their personal gain. This sentencing should serve as a warning to others who might engage in these types of schemes.”
“Kickback arrangements can compromise medical decisions and threaten the integrity of federally funded health care programs,” added Tamala E. Miles, special agent in charge at the U.S. Department of Health and Human Services Office of Inspector General. “Today’s sentence exemplifies our commitment to protecting taxpayer-funded health care programs and the patients they serve.”
Robson’s case is related to a series of cases involving health care fraud and kickbacks through pain clinics, specialty pharmacies, and a nerve conduction company in north Alabama.
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