JACKSON, Miss. - Four Mississippi residents are accused of defrauding insurers of more than $200 million, the latest indictments in a still-unfolding investigation into pharmacies that prosecutors say bribed health care providers to prescribe handcrafted high-dollar medications that were in many cases unnecessary.

Indictments against Hope Thomley and Randy Thomley of Hattiesburg, Glenn Beach Jr. of Sumrall, and Gregory Parker of Laurel were unsealed Monday in Hattiesburg. The Thomleys and Beach were associated with Advantage Pharmacy, one of the businesses that authorities place at the centre of the scheme. Advantage pharmacist Jason May of Hattiesburg and marketer Jay Schaar of Gulfport pleaded guilty earlier.

As previously alleged, Beach, May and others figured out how to make compounded medications that insurers would pay high prices for, "regardless of the individual medical needs of the beneficiaries or the effectiveness of the high-yield compounded medication," according to the indictment. Some prescriptions were worth more than $10,000 apiece.

Marketers recruited dentists, physicians, nurse practitioners and others to writing bogus prescriptions to patients they never examined, prosecutors allege.

"The defendants and their co-conspirators created pre-printed, check-the-box prescription forms," the indictment states. Prosecutors allege pharmacy owners paid kickbacks of a certain percentage of revenue to prescribers as well as the marketers they signed up. Prosecutors document millions in payments to marketing companies they say made the kickbacks.

Hope and Randy Thomley face 24 and 23 felony counts, respectively, including conspiracy, health care fraud and money laundering. Beach faces 16 counts. Parker, a nurse practitioner accused of prescribing medications to patients without examining them and lying to federal investigators, faces eight counts.

Beach pleaded not guilty Monday before U.S. Magistrate Judge Michael T. Parker and was released on $25,000 bail. Gregory Parker did not enter a plea and was released on $25,000 bail. The Thomleys are scheduled to be arraigned Tuesday. Hope Thomley and lawyers for Beach didn't immediately respond to emails seeking comment Monday, but they have denied wrongdoing in a civil lawsuit that seeks to seize their assets.

"The government believes Hope Thomley is a bad and greedy person with millions of dollars in dirty money. It could not possibly be more wrong about her," wrote lawyer Paul Calli in February in a parallel civil case. "Hope is a wife, mother, and grandmother. A former health care executive, Hope is a self-made woman who has worked hard and worked honestly for everything that she has."

As part of the prosecution, the government is trying to seize $17 million in cash, six vehicles and 16 pieces of real estate from the Thomleys and Beach. Those assets have been frozen in the civil case for more than two years pending the criminal investigation.

Among the health care professionals already convicted is a 78-year-old Ocean Springs physician sentenced to 3 1/2 years in prison. An Alabama nurse practitioner also has pleaded guilty.

One product Advantage offered was a "dietary supplement" made with over-the-counter ingredients for which insurers paid thousands of dollars per bottle, according to court documents.

"Get me rolling on dietary supplements," the indictment alleges Parker texted to Hope Thomley in 2014. "I need to make some cash, and I think I can burn through a lot of that stuff!"

Another formulation contained ketamine, a controlled substance, it said. The Thomleys face additional charges for dispensing that without a valid reason.

Prosecutors say Advantage also waived copayments under the table, even though it wasn't supposed to, because the conspirators knew patients would refuse expensive medications if they had to pay.

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News from © The Associated Press, 2018