In an ongoing investigation of a large-scale prescription fraud conspiracy in Alabama conducted with the cooperation of FBI, HHS-OIG, DCIS, USPI and IRS and local law enforcement, the prosecution recently announced that the co-owner and executive of a pharmacy involved in the conspiracy has already filed a guilty plea to the district courts, in admission of the allegations about his participation in a prescription fraud operation in connection to health care fraud in deceiving health care insurance programs.
The defendant, Jeffrey Black, a 55-year old Florida resident, is the former co-owner and executive of Northside Pharmacy ( also known as Global Compounding Pharmacy), based on Haleyville, Alabama. Black has recently filed a plea admitting his involvement in a conspiracy to deceive health care programs through fraudulent prescriptions for unreasonable medications and claims for reimbursements, paying commissions for individuals to issue illegal prescriptions for no reasonable medical purpose and another charge for splurging the reimbursements stolen from the health insurance programs.
State lawyer, Jay Town stated that it is a fact that crimes against the health care system have caused loss of billions of funds every year. The huge and vital impact of this loss can be felt through higher premiums by the taxpayers and the beneficiaries of the health care programs, who are being deprived of affordable health care treatments and services every time fraudsters steal funds for their own financial gain. Town emphasized that Black’s plea along with the others before him, should serve as a warning to other individuals who plan to dupe the health care programs; that the authorities will pursue and apprehend them for their crimes against the government and the community.
FBI agent, Johnnie Sharp Jr. criticized the actions of Black and his co-conspirators, who chose to ruin their reputations for a share of the reimbursements stolen from the health care programs. He highly praised the commitment and effort of all the law enforcement agencies and other partner agencies that have painstakingly did their best to apprehend individuals like Black who take advantage of the health care system and waste the funds contributed by the taxpayers.
DCIS Agent, Cynthia Bruce expressed her office’s commitment to apprehend and prosecute fraudsters like Black who had deceived TRICARE (the healthcare program that aimed to provided healthcare benefits to the military and its veterans) with fraudulent requests for the reimbursements of treatments and services that were not rendered to the beneficiaries or were not needed for medical reasons. She praised the efforts of the state lawyers and law enforcement agencies who have made Black and others before him to be held accountable and liable for their offenses, as well as requiring them to compensate for the funds that they have stolen from the government health programs.
HHS-OIG agent, Derrick Jackson expressed his admiration of the cooperation of multiple agencies to protect the government healthcare programs, resulting to the admission of guilt of the perpetrators of healthcare fraud. He reiterated that his office will continue its efforts in cracking down massive conspiracies similar to the one started by Black.
Postal Inspection official, Adrian Gonzalez said that the admission of guilt announced by Black was a proof of how healthcare fraud has stolen billions of funds from the people and the government, funds that were meant to provide the beneficiaries with affordable medical services. He emphasized that with each fraudulent claim, it increases the amount of premiums and beneficiaries are forced to pay their medical needs using their own money instead of being covered by the health insurer. He emphasized that the USPIS will cooperate with the investigations so that no crook can take advantage of the U.S. Mail service in conducting their criminal acts.
IRS agent, Andrew Thornton Jr. declared that Black’s admission of guilt should act as a caution to other medical practitioners who are thinking of using their patients for their own financial gain. He strongly stated that anyone who would dare try to commit health care fraud will be apprehended and penalized heavily for their offenses. He vowed that the IRS will be steadfast in its resolve to cooperate with other agencies in bringing these fraudsters in front of the courts and making them pay for their unlawful deeds.
Jeffrey Black is just one of the 23 other individuals who have admitted their guilt about their involvement with the massive conspiracy of fraud and kickbacks. Several others apprehended before Black were medical practitioners such as nurses, a sales executive, managers and several pharmaceutical sales representatives.
Based on the statements Black had given as part of his guilty plea, he admitted to being a major participant in a wide-scale conspiracy wherein his pharmacy’s role is to issue requests for the reimbursement of prescription medications that were not needed by the patients or are outside any reasonable medical purpose. Black also admitted that he had committed several other offenses as part of the conspiracy, namely:
– Offering and giving bribes and commissions to physicians and medical assistants to release illegal prescriptions for no medical reason or purpose
– Instructing his pharmacy staff to acquire medications for themselves, relatives and acquaintances for no apparent medical reason or purpose using fraudulent prescriptions filled at his company and other collaborator pharmacies
– Modifying and falsifying prescriptions so that unnecessary medications not needed by the patients are added in the document
– Accepting and filling prescriptions without checking if it is really needed by the patient
– Providing discounts and waivers to persuade patients to continuously refill the prescription medications even if they do not need them
– Requesting for reimbursement claims even without the consent of the patient beneficiaries
According to Black himself, when audits were made by prescription drug administrators, he and his co-conspirators would evade detection by falsifying and manipulating records and information and transferring the fraudulent transactions to other associated pharmacies in the conspiracy circle.
Black’s conspiracy was primarily targeted on different health care insurance programs including Blue Cross Blue Shield, Medicare, TRICARE, CHAMPVA and Medtronic. He didn’t discriminate on his targets, even if they are persons with disabilities, senior citizens, military members and veterans, Black still duped them selfishly. Moreover, he specifically deceived Medtronic, a supplier of medical equipment, multiple times. Black admitted that he had offered commissions to coax individuals who are covered by Medtronic’s health care programs and instructed them to acquire prescriptions for medications that they do not need for any medical reason. He would then give them a share of the reimbursements he got from Medtronic. The defendant and family member had also acquired unreasonable prescriptions for expensive $20,000 per tube scar and wound creams.
On his sentencing trial, Black is facing at most 45 years in imprisonment for the charges of health care fraud, mail fraud, illegal kickbacks and splurging the money he had stolen from the insurers. He will also be liable to pay a million dollars for all the four charges against him, as well as the possibility of treble damages.
Massive health care fraud conspiracies such as the prescription fraud scheme Black was involved in wouldn’t have been possible if there is at least one person in that scheme who had the conscience of reporting the unlawful acts to the authorities. It is worrying that the medical practitioners whom patients and the community trusted can knowingly participate in an obviously criminal act just for the sake of financial gain. The efforts of the authorities to apprehend and prosecute these fraudsters are indeed admirable and they should continue to safeguard the health care system as it is a vital service that the community needs.
Our talented defense lawyers at Healthcare Fraud Group are steadfast in their resolve to provide legal assistance to our clients in disputes related to healthcare fraud. We are dedicated to listening to our clients’ concerns and offering them advice on the best solution possible in their situation. If you or anyone you know is somehow involved in a health care fraud conspiracy, either as a victim, a witness, a conspirator or a falsely accused accomplice, you reserve the right to getting a good defense lawyer to represent you in your court appearances. Let’s discuss about your concerns, call us now at 888-402-454.
