Florida Man Pleads Guilty in Scheme Involving Medically Unnecessary “Foot Baths”

A Florida man has pleaded guilty to charges of conspiracy to commit health care fraud and conspiracy to violate the anti-kickback statute in a scheme that defrauded private health insurance funds, Medicare, and Medicare-sponsored prescription drug plans through the billing of medically unnecessary prescription drug combinations, often referred to as “foot baths.” According to the U.S. Attorney’s Office for the Middle District of Pennsylvania, Frank Suess, 79, of Wellington, Florida, admitted to his role in the fraudulent operation between 2019 and 2020. As part of his plea agreement, Suess has also agreed to forfeit a commercial property in Wellington, Florida, valued at approximately $4 million, which was used to facilitate his illegal activities.

The scheme involved billing insurance providers for prescription drug combinations that were purported to be an antibiotic and antifungal “foot soak” treatment. Patients were instructed to mix these drugs and dissolve them in a warm water solution within a plastic foot tub. The drug combinations frequently included high-cost medications not intended or approved for such use, such as vancomycin capsules, tobramycin vials, calcipotriene cream, moxifloxacin eye drops, clindamycin phosphate solution, and ketoconazole cream. Suess also acknowledged that he and his co-defendants gained control of several pharmacies, including Sterling Pharmacy in Jermyn, Pennsylvania, DCE Pharmacy in Texas, and Motto Pharmacy in Florida, to conceal his involvement in their business operations. He financed the purchase and initial operating expenses for Sterling Pharmacy through a loan to a co-defendant.

The pharmacies were allegedly selected to fulfill prescription drug orders based on their ability to bill specific insurance plans and the amounts they could charge for these medications. To further their illicit gains, Suess and others allegedly steered high-cost prescription drug mail orders, including the “foot baths,” to these controlled pharmacies. When these dispensing practices drew scrutiny from investigators, Suess and his associates reportedly employed various methods to maintain the concealment of Suess’s leadership role. Furthermore, they secured control of multiple pharmacies to ensure continued profits from prescription drug mail orders, even if one pharmacy faced suspension or termination by a pharmacy benefit manager due to its business practices.

The conspirators allegedly obtained pre-checked, templated order forms, often through “health fairs” in the New York area, for large quantities of expensive prescription drugs. These forms were pre-marked to allow for multiple refills without requiring further patient evaluation or medical provider involvement. Suess admitted that neither he nor his co-defendants made any attempt to confirm whether the individuals receiving these orders actually wanted or agreed to receive the “foot bath” drugs before fulfilling them.

The plea agreement also revealed that Suess and his co-conspirators were aware of complaints from individuals who received the “foot baths.” These complaints included recipients stating they did not want the products, had never seen a foot doctor, had their insurance charged substantial amounts, were alarmed by the lack of instructions for the medications, and were frightened by the large quantity of drugs in the “foot bath” boxes. Billing for “foot baths” through Sterling Pharmacy reportedly ceased only after insurance companies stopped processing its orders. Despite repeated rejections from insurance companies, Suess and others continued to attempt billing for similar prescription drug orders in 2021.

In addition to health care fraud, Suess admitted to conspiring to violate the federal Anti-Kickback Statute. This involved agreeing to pay, and actually paying, kickbacks to certain individuals for providing completed orders for “foot baths” obtained through the templated order forms. Suess stated these payments were made with the knowledge that the prescription drug orders were not legitimate. Moreover, he and others allegedly made payments to third-party marketers to generate pharmacy orders for prescription drug products and medical equipment, such as pain creams, skin products, and diabetic support items.

Suess also confessed to obstructing the government’s investigation into Sterling Pharmacy. This involved creating a document, a “marketing services agreement,” that misrepresented the pharmacy’s compliance with the Anti-Kickback Statute and contained other false information. This document was designed to falsely appear that Sterling Pharmacy was paying MedX Marketing Solutions, a company owned by a co-defendant, for legitimate marketing services on an hourly basis, when in reality, it was a payment of illegal kickbacks for the referral of completed “foot bath” order forms. The health care fraud conspiracy generated over $700,000 in profits from fraudulent “foot bath” orders. Suess has agreed to pay restitution for fraudulent orders generated by the pharmacies involved in the charges.

The investigation was a collaborative effort between the U.S. Department of Health and Human Services Office of Inspector General and the Federal Bureau of Investigation. Assistant U.S. Attorneys Ravi Romel Sharma and Sarah Lloyd are prosecuting the case. The maximum penalty for each offense is 10 years of imprisonment, supervised release, and a fine.

Article by Mel Anara, based upon information from the U.S. Attorney’s Office, Middle District of Pennsylvania

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