Doctors plead guilty to health care fraud

Two physicians from Cleveland, Tenn., have admitted to cheating the military’s health care program, TRICARE, out of more than $65 million by writing thousands of expensive, unnecessary prescriptions to patients they never examined.

In a San Diego federal court last week, Dr. Carl Lindblad and Dr. Susan Vergot pleaded guilty to conspiracy to commit health care fraud for their operations at Choice MD, a walk-in clinic on Candies Creek Ridge Road.

The two doctors worked with a team of co-conspirators to obtain patient information from TRICARE-enrolled Marines and their families — mostly from the San Diego area — and write prescriptions for costly, custom-made drugs to those individuals, according to a news release from the Southern California U.S. Attorney’s Office.

The case is one of several across the country concerning TRICARE and specialty drugs known as compounded medications, according to the San Diego Union-Tribune, which first reported on the investigation.

When a physician determines an existing drug won’t work for a particular patient, such as in the case of an allergy or special dosage, a pharmacist can compound a medication to meet the individual’s medical needs.

The Union-Tribune reported that in early 2015, the costs of claims to TRICARE for compounded drugs surged to more than $1 billion and pointed investigators to a pharmacy in Utah issuing prescriptions to patients in Southern California.

Most of those prescriptions were authorized by Lindblad and Vergot who practiced in Tennessee at Choice MD.

Once signed by the doctors, those prescriptions weren’t given to the beneficiaries, but sent directly to particular pharmacies controlled by co-conspirators, which filled the prescriptions and billed TRICARE at exorbitant prices, according to the news release from the U.S. attorney.

Lindblad and Vergot represent the fifth and sixth defendants charged in relation to the scheme, and their sentencings are scheduled for June 29.

Jimmy and Ashley Collins, the owners of Choice MD, were indicted in March on charges of conspiracy to commit health care fraud and illegal payments of remunerations. That case remains pending.