Owner Of Pharmacies In Pensacola And Jay Sentenced In $4.8 Million Federal Fraud Case

May 14, 2021

The owner of a former Escambia County compounding pharmacy that later purchased and involved Jay Pharmacy in the scheme has been sentenced to federal prison in a $4.8 million federal fraud and money laundering conspiracy case.

Andrew E. Fisher, 35, of Gulf Breeze, was sentenced to 24 months in federal prison after a jury found him guilty last year of conspiring to use his pharmacy to defraud TRICARE, a federal health care program for uniformed service members, retirees, and their families, and conspiring to launder the funds generated by the fraud. Fisher was also ordered to pay over $4.8 million in restitution to TRICARE and forfeit an over $3.8 million money judgment sentence was announced today by Jason R. Coody, acting United States attorney for the Northern District of Florida.

Between October 2014 and December 2015, Fisher, the owner and operator of Physician Specialty Pharmacy (PSP) in Pensacola, conspired with sales representative Michael Scott Burton and others to defraud TRICARE out of more than $4.8 million in fraudulent claims for prescription compounded pain cream, scar cream, and wellness vitamins.

During the conspiracy, Fisher also purchased Jay Pharmacy in Jay, and used its existing insurance contracts with TRICARE and others to bill for fraudulent PSP prescriptions. NorthEscambia.com was there when the Jay Pharmacy was raided in February 2016.

Fisher agreed to fill prescriptions at PSP from a doctor’s office in Georgia whose beneficiary information was provided by Burton and individuals working for him, knowing that these particular beneficiaries had never seen that doctor and the prescriptions were not based on a legitimate doctor-patient relationship. In exchange for recruiting TRICARE beneficiaries to receive the prescriptions, Burton received approximately 50% of the amount paid to Fisher in insurance reimbursements. Those commission payments were laundered in the form of large wire transfers and direct deposits into Burton’s bank account in Georgia.

As part of the scheme, Fisher, who is not a licensed pharmacist, directed his pharmacist employees to use ingredient formulations for the drugs that would maximize the amount his pharmacy could bill to TRICARE — which was upward of $10,000 to $17,000 per medication at the time — and other insurance companies without considering what was best for patient care. Fisher also directed Burton and his employees to tell beneficiaries not to worry about co-payments, in order to ensure that the beneficiaries would not decline receiving the medications over out-of-pocket cost. Because PSP was not a TRICARE network pharmacy, Fisher paid Burklow Pharmacy in Pace a commission
of approximately 15% to allow PSP to bill TRICARE using Burklow’s network provider contract for prescriptions received, filled, and shipped at PSP, including ones Fisher knew were fraudulent.

Assistant United States Attorney Alicia H. Forbes prosecuted the case following a joint investigation by the Federal Bureau of Investigation, Defense Criminal Investigative Service, Florida Department of Law Enforcement, Florida Department of Financial Services-Bureau of Insurance Fraud, Florida Department of Health, Naval Criminal Investigative Service, and Army Criminal Investigative Command.

Pictured: State and federal agencies raided the Jay Pharmacy in February 2016. NorthEscambia.com photos, click to enlarge.


Comments

5 Responses to “Owner Of Pharmacies In Pensacola And Jay Sentenced In $4.8 Million Federal Fraud Case”

  1. Layla on May 17th, 2021 3:29 am

    This is such a shame. Jay Pharmacy was a valuable resource for the Jay community prior to this timeframe. To see what actually happened when it closed unexpectedly is terrible. A monetary slap and a 2 year sentence do not due justice to the inconvenience many people experienced in this small community.

  2. Deborah Daugherty on May 14th, 2021 6:58 pm

    I’m in the wrong business…slap on the wrist..he will be out in 2 years only to probably scheme again..

  3. EMD on May 14th, 2021 9:54 am

    Too despicable for words.

  4. Rasheed Jackson on May 14th, 2021 7:11 am

    No wonder there is so much fraud in this country. A person or persons steals more than 4 milllion dollars from the taxpayers and his sentence is pay back what you stole and spend 24 months in federal prison. Hardly a punishment that fits the crime.

  5. Jesse on May 14th, 2021 4:39 am

    I used to get pain medication filled there and I began to notice it was not at all effective. Fill at another pharmacy surprise surprise it worked very well. Pretty sure the ingredients were tampered with. Been on medication for years and very sensitive to its effects being that I didn’t take everyday only as needed. J confirmed my suspicion with a simple drug test at my doctor’s office when no opiates where detected. This was in 2013. Wonder how many others suffered or if they pick and chose

Written by William Reynolds · Filed Under News