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National Insurance Crime Bureau

Two Convicted For Conspiracy To Commit Healthcare Fraud Related To Kickbacks Involving Compounded Prescriptions And Tricare Beneficiaries

United States Attorney’s Office, Middle District of Florida, October 20, 2021

Jacksonville, Florida – A federal jury has found Scott Balotin (51, St. Johns) and Thomas Jones (52, Jacksonville) guilty of conspiracy to commit health care fraud and money laundering. Each faces a maximum penalty of 10 years in federal prison. The sentencing hearings are scheduled for January 18, 2022.

Balotin and Jones had been indicted on October 30, 2019.

According to evidence presented at trial, Balotin owned and operated Casepark, a marketing firm in Jacksonville. Casepark utilized sales representatives to market compounded medication, including creams for pain and scars, to health care benefit program beneficiaries. The creams had very high reimbursement rates, ranging from approximately $4,000 to $17,000, for a one-month supply. Casepark focused its promotional efforts on TRICARE beneficiaries, based upon an understanding and belief that TRICARE would pay claims for the compounded medications. The prescriptions generated for the recruited TRICARE beneficiaries were directed to various pharmacies to be filled. Casepark received approximately 55 percent of the after-cost amount of each claim paid by a health care benefit program to a pharmacy that filled each prescription. Casepark and other alleged co-conspirators paid the sales representatives a percentage of the paid claims they received from the pharmacies.

Other co-defendants who previously pleaded guilty to conspiracy to commit healthcare fraud related to this case include: Pablo Ortiz, Derwin Allen, David Stevens, and Sam Todd.   

This case was investigated by the IRS – Criminal Investigation, the U.S. Postal Service – Office of Inspector General, and the Defense Criminal Investigative Service. It is being prosecuted by Assistant United States Attorneys Ashley Washington, Mai Tran, and Julie Hackenberry.

News article: https://www.justice.gov/usao-mdfl/pr/two-convicted-conspiracy-commit-healthcare-fraud-related-kickbacks-involving-compounded