Consolidated Mail Outpatient Pharmacy

Consolidated Mail Outpatient Pharmacy

The Consolidated Mail Outpatient Pharmacy (CMOP) initiative of the United States Department of Veterans Affairs provides mail order prescriptions to veterans using facilities with highly automated distribution systems at strategic locations throughout the country.



During the 1970s and 1980s, the VA began experimenting with the consolidation of mail prescription workloads. By 1994, it was ready for a computerized test project.

Joseph Haymond, a pharmacist, instituted a manual filling system at the Leavenworth VA Hospital in the 1980s and processed all mail requests from Leavenworth VA and Topeka VA. He then transferred to the Nashville VA and, working with engineers from Baxter, Inc, developed the first prototype machines that led to the full development of the automation in the CMOPs. Mr. Haymond led the development of the Murfreesboro CMOP development project in an old supply warehouse in Murfreesboro, which was the first of the "new" CMOPs. The original Leavenworth CMOP was built in a multi-story building that was not as efficient as the new CMOP in Murfreesboro. The success of the Murfreesboro project led to the creation of the new type CMOPs listed below.

The CMOP program is now serving the entire country from seven locations: Chelmsford, Massachusetts; Lancaster, Texas; Hines, Illinois; North Charleston, South Carolina; Leavenworth, Kansas; Murfreesboro, Tennessee; and Tucson, Arizona.

There are plans for an eighth CMOP to be built in the Seattle, Washington area.


The CMOP program fills continuation of therapy or refill prescriptions only. Initial prescriptions are written for veterans at one of the Veteran Administration's health care facilities. When a refill is needed, the heath care facilities process the prescriptions. The CMOP then uploads this information from multiple facilities in its region. Once filled, the US Postal Service or Fed-Ex or DHL delivers the prescriptions. The health care facility or clinic is notified of the prescription's completion electronically. As of 2000, the annual workload was near 50 million prescriptions. Processing and filling prescriptions took two days; three more days were required for mail delivery.

Government efficiencies

Because of congressional interest in exploring if CMOP could provide cost savings for Department of Defense beneficiaries picking up outpatient refill prescriptions from military treatment facilities, the DOD and VA conducted a pilot program in FY 2003. In its 2005 report, GAO-05-555, the Government Accountability Office (GAO) found that the DOD could generate savings because CMOP's size allows it to negotiate volume discounts.


"Anyone with information concerning bid riging, fraud, kickbacks, bribery or other crimes relating to violations of federal procurement laws" at any of the 7 VA CMOPs or CMOP National Offices by current or recently retired employees "should contact the Chicago Field Office of the Antitrust Division at 312-353-7530 or"

June 30, 2008 the US Department of Justice released information that the former director of the Hines, Il VA CMOP, Joel Gostomelsky, agreed to plead guilty to conspiracy and accepting illegal gratuities.

The plea agreement was filed June 30, 2008 in U.S. District Court in Chicago. Gostomelsky "admitted to conspiring with a subordinate between 2000 and 2007 to allow the subordinate to be involved in the hiring and supervising of temporary pharmacist employees supplied to the CMOP by a company owned by the subordinate's spouse." Gostomelski initially was not telling the truth to the VA when he stated the subordinate had played no part in the ordering of this service and that the subordinate would not be involved with making decisions affecting the employees of the temporary staffing company.

Gostomelsky plead guilty to receiving illegal gratuities form 1998 till approximately 2005 from another vendor that also provided service to the CMOP in Hines, Il. He further admitted that the illegal gratuities helped him give contracts to the vendor providing the illegal gratuities.

He was the director of the CMOP in Hines from 1995 until April 2007. He faces up to 5 years in prison and up to $250,000 fine for one count of conspiracy and up to 2 years of imprisonment and up to $250,000 fine for one count of accepting illegal gratuities.(But only served 4 months for assisting government against subordinate case). This plea agreement is subject to the court's approval.

On November 29, 2005, two employees at the Murfreesboro, Tennessee CMOP, Joseph Haymond and Natalie Coker, were indicted for accepting kickbacks from a vendor selling red tape. In addition, vendor R. Michael Walsh was indicted.

From about August 1999 to July 2001, R Michael Walsh sold more than 100,000 rolls of red tape to the CMOP. Walsh paid his supplier about $2.50 per roll of tape, but Haymond instructed Walsh to charge the CMOP $6.51 per roll, a markup of more than 150%, and to give Haymond and Coker a kickback of $1.00 each for every roll of tape he sold to the CMOP. Coker and Haymond instructed CMOP employees to buy the tape in increments of less than $2,500 so that the CMOP employees could use their government credit cards, thereby avoiding using the VA's Acquisition Service Center. Coker and Haymond each received more than $100,000 in kickbacks from Walsh related to the red tape he sold to the CMOP at inflated prices.

On November 30, 2005, Haymond died of a self-inflicted gunshot wound outside his home in Auburntown, Tennessee. The case against him was dismissed on December 7, 2005.

On March 24, 2006, Walsh plead guilty to one count of Conspiracy to Defraud the United States.

Coker was charged with one count of conspiracy to defraud the United States, three counts of acceptance of bribes by a public official and one count of having a conflict of interest by participating as a government official in a matter involving a company with whom she was negotiating for prospective employment in violation of Title 18, United States Code, Sections 371, 201(b)(2) and 208(a) and 216(a)(2), respectively. On March 24, 2006, Coker plead guilty to the conflict of interest charge. Coker began serving a 46-month prison sentence at Alderson Federal Prison on December 18, 2006. With time off for good behavior she will be eligible for release sometime in April, 2010. The January minutes of the Tennessee Department of Commerce and Insurance disciplinary board shows that Natalie Coker's pharmacy license has been revoked due to "unprofessional conduct".

The third defendant in the case to plead guilty, Robert Michael Walsh, received 36 months probation and will be required to make restitution in the sum of $263,620. Mr. Walsh was given consideration for his complete cooperation and was given financial credit for having paid excess income tax of approximately $120,000. He had paid taxes on the kickbacks given to the other conspirators along with his own profit.

During Mr. Walsh's sentencing hearing it was brought out that the last conspirator who received monies from this enterprise, Dick Pruitt, has not been charged with any criminal offense. Dick Pruitt accepted about $20,000 from the scheme but was bought out early on by Mr. Walsh.


US House of Representatives, Committee on Veterans Affairs, Subcommittee on Oversight and Investigations. May 25, 2000. Testimony of John E. Ogden, M.S. Chief Consultant for Pharmacy Benefits Management, Department of Veterans Affairs. VA's Consolidated Mail Output Pharmacy Program.

United States of America v. Joseph Haymond, Case 3:05–03107. United States District Court, Middle Tennessee District, Nashville Division.

United States of America v. Natalie Coker and R. Michael Walsh, Case 3:05-00232. United States District Court, Middle Tennessee District, Nashville Division.

"VA Suspect Takes Own Life". The Daily News Journal, Murfreesboro, Tennessee. December 1, 2005.

United States District Court for Middle District of Tennessee at Nashville - Transcripts from the Sentencing hearings of Natalie Coker and Robert Michael Walsh.

Department of Justice, "Illinois Veterans Affairs Official Pleads Guilty to Conspiracy and Accepting Illegal Gratuities" June 30, 2008

External links

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