A Cleveland, Tn., man is pleading guilty to health care fraud in a "cream scheme," authorities said.
George Striker worked as a business account executive at Charter Communications.
Prosecutor Perry Piper said Striker "was an acquaintance of an individual who was marketing fraudulently inflated compounded topical creams and medications. Initially, the defendant ordered creams/medications for himself. Later, the defendant was approached regarding the defendant's participation in marketing the creams/medications.
"The defendant agreed to market the creams and to recruit customers to order the creams/medications. The defendant ordered compounded creams for himself for which he was paid a commission. Also the defendant recruited and signed up numerous co-workers from his place of employment, Charter Communications, and many of the co-workers received the creams.
"The customers who ordered the creams were informed that there would be no cost to them to order the compounded medications. These customers were sometimes contacted by a health care professional, via telephone, in order for the prescription to be signed and authorized.
"The doctors/health care practitioners were employed by Jerry Wayne Wilkerson, another conspirator in the case. Even though a health care professional may have contacted the individuals ordering the creams/medications, there was no real doctor/patient relationship which was established.
"The defendant also ordered creams for his minor children and stepchildren, again for which he received commissions. The defendant's children and stepchildren were not contacted by a health care professional to authorize the prescriptions and the children and step-children had no need for the medications/creams.
"The defendant received his commissions through a conspirator, Michael Chatfield. The defendant would pay a cash bonus to his co-workers who ordered the creams. The defendant would inform the customers that they would pay no money out of their pocket for the compounded medications.
"The prescriptions, or order forms, of the customers were sent to doctors/health care professionals in Chattanooga, in the Eastern District of Tennessee, where those forms were then forwarded to a pharmacy which was generally located out of state. The pharmacies who filled the prescriptions were paid through Charter Communications' health insurance provider, Express Scripts, Inc. Express Scripts is an insurance company doing business in interstate commerce and affecting interstate commerce. Express Scripts provided health insurance policies to various companies, including the defendant's employer, Charter Communications. Express Scripts is also a Pharmacy Benefit Manager (PBM).
"The defendant only targeted customers who had insurance that would pay for the creams and medications. The customers recruited by the defendant were not actively seeking the compounded medications. The defendant, and other marketers, sought out the customers in order to recruit the customers to sign up for the compounded medications, thereby allowing the defendant and others to charge large sums to the insurance companies for medications for which there was no real need.
"The scheme used false and fraudulent pretenses in that there was no real medical need for the compounded medications, the defendant (and others) were receiving excessive compensation for the medications, and the customers were induced to order the creams, both with the guarantee that there would be no money out of their pocket and by paying the customers a fee for a ''survey."
"As part of this plea agreement, the defendant agrees that he committed health care fraud by conspiring with others to participate in a scheme and artifice to defraud a health care benefit program and to obtain, by means of false and fraudulent pretenses, representations, and promises, money and property owned by, and under the custody and control of, a health care benefit program in connection_with the delivery of and payment for health care benefits, items, and services."