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A Sandy Springs man received a 5-year prison sentence and agreed to pay $950,000 for his role in a Tricare and Medicare fraud scheme.
Brett Sabado, 34, of Sandy Springs, was sentenced by U.S. District Judge Thomas W. Thrash Jr. His prison sentence will be followed by three years of supervised release.
Sabado and his co-conspirators received illegal kickbacks for Tricare referrals and prescriptions designed to maximize profits, according to U.S. Attorney Ryan K. Buchanan, the charges and information presented in court.
Sabado operated a pharmaceutical company – NHS – that caused compounding pharmacies to submit false claims for these prescriptions to Tricare, a U.S. Attorney’s Office press release reported. The pharmacies paid NHS part of the Tricare reimbursement, and NHS paid a portion of its proceeds to healthcare marketing companies that pushed providers into prescribing these unnecessary medications.
Sabado created an online portal database used to refer prescriptions through NHS to the compounding pharmacies. Its data helped Sabado and others track the referrals made to pharmacies and to invoice them for the illegal kickbacks to NHS.
Sabado caused a loss of $4.5 million to Tricare, the release said. Tricare is a health program for uniformed service members and their families and National Guard/Reserve members.
He also was alleged to have conspired with direct medical equipment supply companies to submit fraudulent claims for medically unnecessary equipment such as arm, leg, back, wrist and neck braces to Medicare. The release reported that Sabada knew the orders were supported by sham prescriptions by telemedicine physicians, who in many cases never spoke with or examined beneficiaries.
He received between $5 and $15 for each medically unnecessary brace that he shipped, plus a percentage of all Medicare reimbursement for them. He caused a loss of almost $70 million to Medicare, according to the release.
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