LOS ANGELES—A former Orange County pharmacist was sentenced April 3 to 15 years behind bars for her role in a health care fraud scheme that bilked the U.S. military’s health care plan out of more than $11 million.
Sandy Mai Trang Nguyen, 43, of Irvine, was sentenced by U.S. District Judge Otis D. Wright II, who also ordered her to pay over $11,000,000 in restitution, according to the U.S. Attorney’s Office.
Nguyen was convicted in November in Los Angeles of 21 counts of health care fraud, and one count of obstruction of a federal audit.
The scheme involved the filling of more than 1,000 bogus prescriptions for compounded medications at the expense of the Tricare health care plan.
Compounded drugs are tailor-made products doctors may prescribe when the Food and Drug Administration-approved alternative does not meet the health needs of a patient.
Nguyen was the lead pharmacist at the now-shuttered Irvine Wellness Pharmacy. From late 2014 to May 2015, Nguyen and others under her supervision filled about 1,150 compounded prescriptions for pain, scarring, and migraines, with Tricare funding reimbursements of tens of thousands of dollars per prescription.
Prosecutors said the bulk of the prescriptions were directed to the pharmacy by so-called marketers who received kickbacks of nearly 50 percent of the Tricare reimbursements.
According to prosecutors, beneficiaries were solicited to provide their Tricare insurance information for medications they did not need, and most were never examined by a physician.
The jury in Los Angeles federal court heard that Nguyen knew the prescriptions were written by doctors who didn’t live in the same state as the supposed beneficiaries. In some cases, multiple members of the same families received the same medications. In one case, a 13-year-old boy in Chicago received the same prescription as an 86-year-old woman in Orange County who turned out to be Nguyen’s grandmother, prosecutors said.
The pharmacy billed beneficiaries for hundreds of dollars in required co-payments, but they balked at the payments, saying they understood the medications were fully covered by Tricare. The total co-payments due during the scheme exceeded $16,000, but the pharmacy never collected them.
Nguyen obstructed a federal audit by providing bogus, cut-and-pasted prescriptions to cover up Tricare’s effort to validate millions of dollars paid for the same prescriptions.
Last month, Marcus Armstrong, 56, of Miami, was sentenced by Wright to 9 1/2 years in federal prison for his role in the scheme. Armstrong was once the director of operations at the Irvine pharmacy. He pleaded guilty in October to two counts of paying illegal kickbacks for health care referrals.
Co-defendants Leslie Andre Ezidore, 53, of West Los Angeles, and Alexander Michael Semenik, 51, of Las Vegas, have pleaded guilty to felony charges in this case and await sentencing.
