Three East Tennessee individuals have pleaded guilty and been sentenced for their roles in a prescription fraud operation involving the Riddle Drugs pharmacy chain, that caused Medicare, drug plans, and pharmacy benefit managers (PBMs) to pay more than $7.3 million, the U.S. Attorney’s Office for the Eastern District of Tennessee announced earlier this month.
The U.S. Department of Justice (DOJ) press release explained that Grant Riddle, Brian Woods, and Barbara Smith all pleaded guilty to one count of conspiracy to commit health care fraud over each of their roles in the procurement, creation, and submission of reimbursement requests related to a formulary, a list of prescription drugs meant to balance “appropriate therapy while promoting effective resource utilization,” created solely based on their high reimbursement values for Riddle Drugs.
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