A federal jury has convicted Tampa, Fla., pharmacy owner Peter Bolos, 44, for his role in running an $174 million telehealth fraud scheme.
Court documents and evidence presented at trial state that Mr. Bolos and several co-conspirators deceived pharmacy benefit managers about at least 60,000 prescriptions between May 2015 and April 2018, tricking them into authorizing false claims worth more than $174 million that insurers paid to pharmacies controlled by the co-conspirators.
To obtain prescriptions, a co-conspirator and telemarketer Scott Roix used his business as a telemedicine service, calling patients and persuading them to accept medication and give up details about their medical insurance. Physicians would then remotely prescribe medication based solely on the information provided by the telemarketer.
Mr. Bolos maximized insurance payments by submitting fraudulent reimbursement claims. Many of the prescriptions were unnecessary and were typically for drugs such as scar creams, pain creams and vitamins. He purposely selected specific medicines that he knew he could submit for highly profitable reimbursements. Mr. Bolos also used illegal means to hide his activity from the pharmacy benefit managers.
Mr. Bolos was found responsible for at least $89 million in the fake billings and convicted Dec. 2 of 22 counts of mail fraud, conspiracy to commit healthcare fraud and introduction of a misbranded drug into interstate commerce.
His sentencing is set for May 19, 2022.