Metairie Man Sentenced to Three Years of Probationfor Health Care Fraud Scheme
Published 2:24 pm Friday, April 8, 2022
NEW ORLEANS – The U.S. Attorney for the Eastern District of Louisiana, Duane A. Evans, announced that MARIO DELUCA (“DELUCA”) has been sentenced on April 6, 2022 to 36 months of probation after pleading guilty in federal court relating to his role in a health care fraud conspiracy.
DELUCA, age 39, a resident of Metairie, Louisiana, pled guilty on February 24, 2021 before U.S. District Judge Jane Triche Milazzo to Count One of a bill of information charging him with conspiracy to commit health care fraud, in violation of Title 18, United States Code, Section 1349.
According to the bill of information, in or around March 2014, continuing through in or around October 2016, co-defendants conspired to knowingly and willfully execute a scheme and artifice to defraud TRICARE, a federal health care benefit program affecting commerce, and other health care benefit programs.
Prime Pharmacy contracted with various entities, including Pharmacy Benefit Managers (“PBMs”), obligating Prime Pharmacy to collect copayments from beneficiaries in order to be reimbursed by various health care benefit programs, including TRICARE. Deluca worked with codefendants to market the compounded medications produced by Prime Pharmacy. Deluca and coconspirators worked with marketers outside of the state to find beneficiaries that were willing to receive medically unnecessary compounds and doctors willing to prescribe compounds without medical necessity.
Beginning in or around March 2014, and continuing through in or around April 2016, Prime Pharmacy dispensed prescriptions for High-Yield Compounded Medications to beneficiaries of TRICARE and other health care benefit programs that were not medically necessary, induced by kickback payments, or where copayments were either waived or credited by Prime Pharmacy, and accordingly, submitted or caused to be submitted false and fraudulent claims for reimbursement to TRICARE, other health care benefit programs, and PBMs.
DELUCA was also ordered to repay TRICARE $777,000 in restitution.
“Individuals involved in this scheme illegally billed TRICARE out of close to $15 million and I am pleased that the U.S. Attorney’s Office is requiring justice,” said Special Agent in Charge Cynthia Bruce, Office of Inspector General, Defense Criminal Investigative Service, Southeast Field Office. “There are no victimless crimes and DCIS agents will continue to pursue unscrupulous greedy individuals who steal from our military health care system and all taxpayers.”
“Those entrusted with providing health care services to veterans and their family members will be held accountable should they violate that trust,” said Special Agent in Charge Jeffrey Breen of the Department of Veterans Affairs Office of Inspector General’s South Central Field Office. “The VA OIG is grateful to the United States Attorney’s Office and our law enforcement partners for their efforts to achieve justice in this case.”
U.S. Attorney Evans praised the work of the Office of Inspector General, Defense Criminal Investigative Service, the Department of Homeland Security, the Department of Veterans Affairs – Office of Inspector General, and the United States Postal Service – Office of Inspector General.
The prosecution of the case is being handled by Assistant United States Attorney Kathryn McHugh.