Criminal Cases

Married Couple Pleads Guilty to $65 Million TRICARE Fraud Scheme

Married Couple Pleads Guilty to $65 Million TRICARE Fraud Scheme

A husband and wife based in Tennessee have pleaded guilty to a $65 million TRICARE fraud scheme.

Jimmy and Ashley Collins, a married couple residing in Birchwood, have admitted that they participated in a health care fraud scheme that cost TRICARE – the health care program that covers United States military service members and their families – out of over $65 million in total.

GettyImages-180690923_resized_soldier
Credit: MoMo Productions/Getty Images

According to an official release from the IRS, the Collins' plea deal confirms that they were part of a network of co-conspirators who recruited existing TRICARE beneficiaries willing to sign up to be prescribed costly compounded medications, even though they didn't really need these medicines.

Compounded drugs are generally very expensive, custom-made prescriptions that doctors sometimes prescribe when FDA-approved mainstream medication does not meet the health needs of a patient. It is not uncommon for military members with PTSD and combat injuries to receive compounded drugs, so TRICARE officials were not initially alarmed.

The beneficiaries' information was sent to Choice MD, a Tennessee clinic the Collinses co-owned and operated. Doctors and other healthcare professionals employed by the couple, including Dr. Susan Vergot, Dr. Carl Lindblad, and nurse practitioner Candace Craven, wrote the requested prescriptions for compounded drugs, though they never reviewed any legitimate medical records or examined any patients.

The IRS explains that the bogus prescriptions never passed through the hands of the straw beneficiares, but were sent directly to The Medicine Shoppe in Bountiful, Utah. The pharmacy then received the massive benefits payouts from TRICARE.

GettyImages-1181008285_resized_soldier
Credit: SDI Productions/Getty Images

Between December 2014 and May 9, 2015, the Choice MD doctors employed by the Collinses authorized 4,442 prescriptions and billed TRICARE $65,679,512 for the illegitimate prescriptions.

The team at The Medicine Shoppe location reimbursed the Collinses with a percentage of the TRICARE payouts they received. The couple netted over $45 million from their scam. 

The Collinses are the last co-defendants to plead guilty in this case. 

The IRS shared that United States government authorities have seized numerous items from everyone involved in this far-reaching scheme. Among "these items is an 82-foot yacht; multiple luxury vehicles, including two Aston-Martins; a multimillion-dollar investment annuity; dozens of pieces of farm equipment and tractor-trailer trucks; and three pieces of Tennessee real estate."

U.S. Attorney Randy Grossman said, "The scheme alleged in this case resulted in massive losses to a taxpayer-funded healthcare program meant to help members and veterans of our armed forces. The days of yachts and luxury cars are gone. With these guilty pleas, we are holding these defendants accountable for their crimes." 

Jimmy and Ashley Collins will be sentenced on October 27, 2023 with U.S. District Judge Janis L. Sammartino presiding.

GettyImages-1346156607_resized_courtroom
Credit: gorodenkoff/Getty Images

In another recent, similar TRICARE fraud case, Orange County, California pharmacist Sandy Mai Trang Nguyen was sentenced to 15 years in federal prison for prescribing unnecessary compounded medications that cost the military health program over $11 million. 

What do you think about this military fraud scheme?

You Might Also Enjoy:

Feature Image Credit: Anchiy/Getty Images

share this post
Search for matches...
Rebekah Barton

Rebekah Barton

Rebekah's search engine optimization career began completely by accident as a college student. Over the course of her career so far, she has "grown up" with the SEO industry, from writing content while juggling classes to managing her own teams of writers and overseeing SEO strategy in subsequent roles. She is excited to bring her passion for high-quality content to CountingWorks, Inc.

Recommended Professionals

In the face of economic uncertainty, TaxBuzz is the industry's most up-to-date tax information.

Join 60,000 who get our weekly newsletter. No spam.

Need help selecting a firm?

Use our specialized search engine and get matched to the best accounting and tax firm for your needs.

Related Posts

Latest Posts