Ohio Man Admits Role in Multimillion-Dollar Scheme to Defraud Health Care Benefit Programs
NEWARK, N.J. – An Ohio man pleaded guilty today to his role in a large-scale, multilevel marketing scheme to defraud private and federally funded health care benefit programs, U.S. Attorney Philip R. Sellinger announced.
Kent Courtheyn, 38, of Kent, Ohio, owner and operator of two marketing companies involved in the sales and marketing of compounded medications – IntegriMed Solutions LLC (IntegriMed) and KA Compounding LLC (KA Compounding) – pleaded guilty by videoconference before U.S. District Judge Madeline Cox Arleo to an information charging him with conspiracy to defraud the United States by committing health care fraud and violating the anti-kickback statute.
According to documents filed in this case and statements made in court:
TRICARE is a health care entitlement program of the U.S. Department of Defense (DoD) Military Health System that provides coverage for DoD beneficiaries worldwide, including active duty service members, National Guard and Reserve members, retirees, their families, and survivors. Compounded medications are specialty medications prepared by a pharmacist to meet the specific medical needs of an individual patient. Although compounded drugs are not approved by the Food and Drug Administration (FDA), they are properly prescribed when a medical professional determines that an FDA-approved medication does not meet the health needs of a particular patient, such as when a patient is allergic to a dye or other ingredient or when a patient cannot consume a medication by traditional means.
From July 2014 through July 2016, Courtheyn, a former medical device sales representative, ran a large-scale scheme to defraud federally funded health care benefit programs, such as TRICARE, as well as privately funded health care benefit programs. Through IntegriMed and KA Compounding, Courtheyn recruited individuals to submit fraudulent claims for medically unnecessary compounded medications, such as pain creams, scar creams, wound creams, and metabolic vitamins, without regard to medical necessity. In total, Courtheyn defrauded health care benefit programs, including TRICARE, of at least $5.8 million.
Courtheyn faces a statutory maximum of five years in prison and a $250,000 fine, or twice the gross gain or loss from the offense, whichever is greatest. Sentencing is scheduled for July 20, 2022.
U.S. Attorney Sellinger credited special agents of the FBI, under the direction of Special Agent in Charge George M. Crouch Jr. in Newark; and the U.S. Department of Defense, Office of Inspector General, Defense Criminal Investigative Service, Northeast Field Office, under the direction of Special Agent in Charge Patrick J. Hegarty, with the ongoing investigation leading to today’s guilty plea.
The government is represented by Assistant U.S. Attorney Osmar J. Benvenuto, Deputy Chief of the Criminal Division in Newark.