Mississippi Physician Convicted in $3 Million TRICARE Pharmacy Fraud

Mississippi Physician Convicted in $3 Million TRICARE Pharmacy Fraud

A federal jury found a 78-year-old Biloxi, Mississippi physician guilty for his role in a $3 million pharmacy fraud scheme, which included military healthcare funds. According to the Department of Justice (DOJ) press release on March 5, the 78-year-old physician, Albert Diaz, was convicted of:

  • One count of conspiracy to commit healthcare fraud;
  • Four counts of distributing and dispensing a controlled substance;
  • One count of conspiracy to falsify records in a federal investigation; and
  • Five counts of falsification of records in a federal investigation following a five-day trial.

Between October 2014 and December 2015 evidence revealed that Diaz defrauded TRICARE, as well as other insurance companies, by prescribing medically unnecessary compounded and controlled medications (including ketamine) to patients he had not examined. He dispensed these medications and received reimbursement from the insurers totaling more than $3 million. After a TRICARE audit, Diaz “falsified patient records to make it appear as though he had examined patients before prescribing the medications,” according to the DOJ press release.

Acting Assistant Attorney General Cronan said, “The prosecution of Albert Diaz exemplifies the Criminal Division’s commitment to holding those involved in fraud schemes accountable for their actions.”

Michelle Dick
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Michelle Dick

Executive Editor at AAPC
Michelle A. Dick has been executive editor for AAPC for over 10 years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. She has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.
Michelle Dick
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Michelle A. Dick has been executive editor for AAPC for over 10 years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. She has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.

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