JACKSONVILLE, Fla. — The price of doing business is more than $7 million for one Jacksonville pharmacy.
That’s the amount the owner of Smart Pharmacy and SP2 will pay to settle a federal lawsuit claiming he defrauded Tricare and Medicare.
Gregory Balotin was reported by two whistleblower employees who said he added expensive prescription drugs into pain creams unnecessarily, and then passed the cost to government insurance providers.
In conversations with billing personnel, one former employee “became aware of many questionable or suspicious practices.”
He noticed scar or pain cream that cost less than $400, would yield a net profit of $6000.
Former federal prosecutor Jason Mehta said it’s one of two dozen similar cases in the Jacksonville area in the past decade.
“Tricare, I think, very purposefully gives out the most generous benefits to those that are willing to give the most to our country,” Mehta said. “Every now and again, there are those providers and those pharmacies out there that want to take advantage of those benefits.”
The $7.4 million settlement does not include any admission of liability.
"Nonetheless, the government took it very, very seriously," Mehta said. "The government is getting millions and millions of dollars back in reimbursement. To me, what it really reflects is that there's a lot of money in healthcare and the government's using all of the tools at its disposal to try to claw back as much as it can when it thinks it improperly paid out money."
Balotin also entered a three-year integrity agreement, which includes annual reviews by a federal inspector. His attorneys did not respond to First Coast News requests for comment.