The CEO of a Houston-based pharmaceutical company was convicted on all 15 charges against him for leading a scheme to fraudulently bill payers for expensive topical creams.
Mohamad Mokbel, 59, of Houston, led 4M Pharmaceuticals, which operated 14 pharmacies with straw owners, according to an Oct. 15 Justice Department news release. From 2014 through 2021, Mr. Mokbel illegally purchased the personal information of thousands of Medicare beneficiaries. He targeted elderly diabetic patients and paid between $16 and $40 per beneficiary.
Mr. Mokbel directed 4M's employees to use the beneficiaries' patient data to run insurance claims to determine if Medicare or other plans would cover and reimburse at a high rate for the topical creams, Omega-3 pills, and other medications that he intended to sell through the pharmacies, according to the release.
The company's employees would then fax pre-filled prescription requests to the patients' physicians, appearing to be for diabetic testing supplies, with topical creams added at the bottom. They also included false representations that the patient was requesting 4M Pharmacy to fill their medications.
The pharmacies shipped out numerous topical creams, often on auto-refill, and "excessively billed" Medicare, Medicaid, and private payers, according to the release.
From 2015 through 2020, Mr. Mokbel also gave a series of bribe payments — totaling more than $180,000 — to an OptumRx employee in exchange for favorable treatment for 4M pharmacies, according to the release.
Mr. Mokbel is scheduled to be sentenced on Jan. 7. In addition to a possible prison sentence, he could also be ordered to pay more than $160 million in restitution and up to $4 million in fines.