45-year-old former pharmaceutical representative Holly Blakely, of San Antonio, TX, pleaded guilty for her role in an $8 million health care fraud scheme that netted her over $1 million.
The 30 count indictment filed in 2017, portrays her as one piece in a conspiracy targeted by a wide-ranging investigation of pharmacies that provide compound pain medication to military veterans and others with private insurance.Investigations of pharmacies that provide compound pain medication took place in at least four states.
Blakely was scheduled for trial in February. Instead she pleaded guilty to one conspiracy to commit wire fraud, health care fraud, bribery, and paying kickbacks. She now faces up to five years in federal prison. She remains on bond pending sentencing scheduled for June 13, 2019.
As part of her plea, Blakely admitted her role in a scheme to defraud health care benefit programs by paying over $400,000 in kickbacks and bribes to health care providers that prescribed compounded medications to individuals who did not need the medications.
She and her co-conspirators attempted to disguise the kickbacks and bribes to health care professionals by writing fictitious and back-dated “consulting agreements.” In many instances, They submitted prescriptions to compounding pharmacies for patients that had never seen a medical professional.
Moreover, Blakely and her co-conspirators would occasionally forge the signature of a medical professional on prescriptions.
Blakely admitted that she conspired with two compounding pharmacies that would submit claims for reimbursement to health care benefit programs for compounded medications based on the prescriptions.
In exchange for her role in the conspiracy, the two compounding pharmacies paid Blakely approximately $1,147,885.14. Health care benefit programs reimbursed the two compounding pharmacies approximately $8,846,972.24 based on the claims submitted in connection with the compounded medications.
in 2015, the federal government reached a settlement with one of them, MediMix Specialty Pharmacy of Jacksonville, Florida, and a top-referring physician, Dr. Ankit Desai, for more than $3.7 million.
Under the deal, the parties resolved allegations that, from Jan. 1, 2009, until December 2014, Dr. Desai sent hundreds of prescriptions to MediMix. Desai was married to a vice president of MediMix.