KNOXVILLE, Tenn. (WATE) — A Florida man is the latest to be found guilty in a multimillion-dollar pharmaceutical scam which defrauded programs such as Medicare and Blue Cross Blue Shield of Tennessee over a nearly three-year period.
Peter Bolos, 44, of Tampa, was convicted by a federal jury of conspiracy to commit health care fraud, 22 counts of mail fraud and felony misbranding of medication.
According to document from the U.S. District Court in Greeneville, Bolos, Andrew Assad, Michael Palso, Maikel Bolos, Larry Smith, Scott Roix, HealthRight LLC, Mihir Taneja, Arun Kapoor, and Sterling Knight Pharmaceuticals, as well as various other companies owned by them, conspired to defraud pharmacy benefit managers, such as Express Scripts and CVS Caremark, out of millions of dollars.
These managing companies pay pharmacies for prescription claims on behalf of public insurance programs, like Medicare and Tricare, and private insurance companies, like Blue Cross Blue Shield of Tennessee.
Bolos, Assad, and Palso – who owned Synergy Pharmacy in Palm Harbor, Florida – purchased prescriptions from Scott Roix for $500 apiece. Bolos and Roix disguised these prescription purchases with marketing agreements.
From May 26, 2015, through April 1, 2018, Bolos paid Roix more than $30 million to buy at least 60,000 prescriptions. Nearly all these prescriptions were issued through HealthRight’s telemedicine platform.
Roix used the telemedicine platform to deceive patients into providing HealthRight with their insurance information. Roix then steered doctors to issue prescriptions through the platform by falsely telling the doctors the patients had requested the medications. The doctors who issued the prescriptions did not know, never met, and never spoke to the patients.
Roix, Assad, Palso, Smith, Maikel Bolos and various associated business entities have already pleaded guilty to their role in the conspiracy. Taneja, Kapoor, and Sterling Knight pleaded guilty to felony misbranding in a conspiracy with Bolos. Sentencings for all the defendants will be set for dates in 2022.
Sentencing for Bolos has been set for May 19 in Greeneville.