Pharmacy owner charged in $10 million health insurance scam

Owner is accused of participating in a scheme to defraud a federal health-benefits program

Pharmacy owner charged in $10 million health insurance scam

Life & Health

By Ryan Smith

An Alabama pharmacy owner has been charged as part of an alleged conspiracy to scam more than $10 million from a federal health insurance program.

John Christopher Lemley was charged Monday, and prosecutors filed a plea agreement with him. The plea deal would require Lemley to forfeit nearly $1 million and a 2015 Lexus he allegedly bought with criminal proceeds.

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Lemley owned Southern Compounding and Apotheca Supply, a Decatur, Ala., compounding pharmacy, according to a report by DecaturLive.com. He also had a 20% interest in Medwork Sunflower, an affiliate of Mississippi-based Medworx Compounding Pharmacy.

Prosecutors said that Lemley conspired with others at Medworx Sunflower and Southern Compounding to defraud TRICARE – the Department of Defense healthcare program that covers veterans, active service members, and their families – and third-party prescription program administrators Express Scripts and Optum Rx.

Lemley allegedly improperly contracted with Medworx Compounding to refer prescriptions to Southern Compounding, DecaturLive.com reported. He also allegedly paid kickbacks for independent sales representatives to refer TRICARE prescriptions, sold misbranded over-the-counter medicine and prescription drugs, and failed to reverse claims on prescriptions he knew were fraudulent.

Lemley faces up to five years in prison if convicted.


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