Evidently, it’s the week of the fraudster pharmacist. In two separate cases reported on this week, pharmacists have been found guilty of committing their own separate versions of health care fraud. The first of the two stories emanates from Red Bud, Illinois.
Steven P. Gibson pleads guilty to health care fraud charges.
As reported by the Randolph County Herald Tribune yesterday, 29 year-old Gibson pleaded guilty in federal court on the 14th of this month. The pharmacist and owner of Gibson’s Discount Drugs in Red Bud was charged with engaging in a scheme to defraud health care benefit programs.
According to the report, Gibson “admitted that he submitted false and fraudulent claims in the names of family members and pharmacy customers for prescription medication, to Medicare, Medicaid and private insurance companies, according to a release from the U.S. attorney’s office. The scripts were not authorized by a physician, nurse practitioner, or a physician assistant as required.”
As part of his scheme, Gibson usually chose expensive prescription medications he knew insurance companies like Medicare and Medicaid would pay for. They included Creon, a drug used to treat chronic pancreatitis; Pentasa, a drug used to treat ulcerative colitis; and Hydroxychloroquine, a drug used to treat or prevent malaria.
“In total, Gibson received payments of over $630,000 from Medicare, Medicaid, and private insurance companies, according to the release,” reveals the Herald Tribune, “Sentencing is set for Nov. 27, at which time Gibson could face up to 10 years in prison, a fine of up to $250,000, and up to three years of supervised release on each of the two counts to which he pleaded guilty.”
Karl O’Dell pleads guilty to conspiracy to misbrand drugs.
As reported by the South District of West Virginia branch of the United States Department of Justice yesterday, 61 year-old O’Dell pleaded to a conspiracy to misbrand the drugs, oxycodone and hydrocodone. The pharmacist and owner of HOPE Clinic in Ashland, Kentucky admitted that he misbranded oxycodone and hydrocodone and introduced them into interstate commerce.
According to the report, O’Dell manufactured compounded oxycodone and hydrocodone not for medically legitimate purposes in anticipation of prescriptions written by HOPE Clinic practitioners for their customers. “On two separate occasions, once in July 2014 and once in August 2014, he received and filled two prescriptions for 120 oxycodone 32mg compounded capsules written by two different HOPE Clinic practitioners for two different customers,” the report details.
O’Dell now faces up to one year in prison as well as a $100,000 fine. His sentencing is scheduled to take place on November 29, 2018. He has also agreed to the filing of a civil complaint for the over $42,000 of illegal proceeds he received as a result of the misbranding conspiracy.
United States Attorney Mike Stuart had this to say about the guilty plea: “West Virginia is in the midst of the worst drug crisis of our time. We will use every federal law available to us to hold those contributing to the opioid crisis accountable, regardless of whether they are a street dealer, cartel leader or a medical professional in a lab coat.”
Are you an attorney working a health care fraud case?
Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help you. Call us at 407-217-5831 or email us at firstname.lastname@example.org.
#RedBud #Medicaid #Ashland #Kentucky #Illinois #healthcarefraud #Medicare #conspiracy #pharmacists