GULFPORT, MS (WLOX) - A Biloxi-based doctor is charged in a 16-count federal indictment for his alleged role in a multi-million scheme to defraud TRICARE, the health care program that serves members of the military, veterans, and their dependent family members.
A news release from the Department of Justice says the indictment charges Albert Diaz, M.D., with conspiracy to commit health care fraud and wire fraud, four counts of wire fraud, conspiracy to distribute and dispense a controlled substance, four counts of distributing and dispensing of a controlled substance, conspiracy to falsify record in a federal investigation, and five counts of falsification of records in a federal investigation.
Diaz, of Ocean Springs, is set to make his initial court appearance before a federal judge on Oct. 31 at 2:30 p.m. If convicted, Diaz faces 305 years in jail and up to $7.5 million in fines.
Federal investigators say Diaz prescribed unnecessary medications, including the controlled substance Ketamine, to patients without examining them first.
The goal of the scheme, according to prosecutors, was to have a Hattiesburg-based pharmacy fill the prescriptions, which would then be reimbursed by TRICARE.
The indictment says TRICARE reimbursed Advantage Pharmacy more than $2.3 million for medications prescribed by Diaz between October 2014 and December 2015.
When Diaz was audited for the prescriptions, investigators said he submitted falsified patient records saying he had examined the patients before prescribing medications.
U.S. Attorney Mike Hurst said Diaz's indictment is linked to two cases prosecuted earlier this year in the Southern District of Mississippi. In July, Jay Schaar, of Biloxi, and Jason May pleaded guilty for their roles in a conspiracy to defraud health benefit programs out of millions of dollars.
May was the co-owner of Advantage Pharmacy, and Schaar acted as a marketer for a pharmacy operating out of Lamar County. Prosecutors said Schaar solicited physicians to write unnecessary prescriptions for medications dispensed by Advantage Pharmacy.
In all, Advantage Pharmacy received $192 million in reimbursements from TRICARE because of the scheme.
The investigation is the largest ever national fraud enforcement action by the Medicare Fraud Strike Force.