Chief Compliance Officer Convicted of $50M Medicare Fraud Scheme

A federal jury convicted a Florida man today for conspiracy to commit health care fraud and wire fraud.

According to court documents and evidence presented at trial, Steven King, 45, of Miramar, was the chief compliance officer of a pharmacy holding company that fraudulently billed Medicare over $50 million for dispensing lidocaine and diabetic testing supplies that Medicare beneficiaries did not need or want. King and his co-conspirators operated A1C Holdings LLC, which held pharmacies in various states, including All American Medical Pharmacy in Warren, Michigan. When A1C secured prescriptions and refills on behalf of its pharmacies for medically unnecessary lidocaine and diabetic testing supplies, it violated Medicare and pharmacy benefit manager rules.

King and his co-conspirators took several steps to conceal their scheme, including enrolling their mail order pharmacies as brick-and-mortar retail locations to evade more rigorous oversight, shipping prescription refills for high-reimbursing medications and supplies without patient consent, concealing the ownership of A1C Holdings LLC and its pharmacies, and transferring patients among pharmacies without patient consent. King and his co-conspirators took each of these steps to ensure that Medicare continued to be billed for profitable medications and supplies. As chief compliance officer, King was in a unique position to prevent and report the fraudulent scheme, but he used his position to defraud Medicare instead.

The jury convicted King of conspiracy to commit health care fraud and wire fraud. His sentencing is scheduled for Sept. 14 and he faces a maximum penalty of 20 years in prison. A federal district court judge will determine King's sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department's Criminal Division, Special Agent in Charge James A. Tarasca of the FBI Detroit Field Office, and Special Agent in Charge Mario Pinto of the Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.

The FBI Detroit Field Office and HHS-OIG investigated the case.

Trial Attorney Shankar Ramamurthy and Acting Assistant Chief Andrew Barras of the Criminal Division's Fraud Section are prosecuting the case.

The Fraud Section leads the Criminal Division's efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.