JACKSONVILLE, Fla — Jonathan Simeon Gholston, 35, of Jacksonville, admitted to conspiring to receive illegal kickbacks for referring Medicare and Medicaid beneficiaries to a local pharmacy for HIV post-exposure prophylactic medications. He faces up to five years in federal prison.
According to court documents, Gholston owned a marketing company that partnered with a Jacksonville pharmacy. Marketers set up tents in low-income areas offering free, government-sponsored cellphones in exchange for personal information. While signing people up for phones, they also collected health insurance details — including Medicare and Medicaid coverage — without individuals requesting or consenting to receive HIV medications.
The pharmacy allegedly used that information to generate prescriptions authorized by a nurse practitioner who had not examined or spoken to the patients. The pharmacy then billed Medicare and Medicaid about $4,000 per month per person for the medications.
Investigators say the scheme led to more than 20,000 fraudulent claims and approximately $24.2 million in reimbursements — about $11.6 million from Medicare and $12.5 million from Medicaid. Gholston personally received about $2.27 million, which he has agreed to forfeit.
Authorities say some recipients were put at serious health risk because they were prescribed medications without proper medical evaluation.
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