Two Accused Convicted of Prescription Fraud Scheme

Two Accused Convicted of Prescription Fraud Scheme

Birmingham, AlabamaOn 1st March 2021, a federal jury sentenced two accused persons in a long-running inquiry into a prescription medication billing conspiracy concerning a Haleyville, Alabama-based pharmacy, Northside Pharmacy d/b/a Global Compounding Pharmacy.  United States Attorney Prim Escalona, Special Agent Johnnie Sharp, Jr. in Charge of the Federal Bureau of Investigation, the  Special Agent Derrick L. Jackson in Charge of the U.S. Health & Human Services Department – Office of Inspector General, Special Agent Cynthia Bruce in Charge of the Defense Criminal Investigative Service, the Inspector in Charge Adrian Gonzalez of the United States Postal – Houston Division, and Acting Special Agent Andrew Thornton in Charge of the Internal Revenue Service-Criminal Investigation made this announcement.

The jury submitted its guilty judgment against Jessica Linton, age 37, from Clearwater, Florida, the billing team manager at Global, and John Gladden, age 50, from Tallahassee, Florida, a district manager overseeing salespersons at Global, after 5 days of attestation before L. Scott Coogler, Chief U.S. District Judge.  Jessica Linton was sentenced on one charge of conspiracy, 13 charges of health care fraud, three mail fraud counts, and seven aggravated identity theft counts. John Gladden was sentenced on one charge of conspiracy, six charges of health care fraud, one mail fraud count, and one aggravated identity theft count.

United States Attorney Escalona stated that the 1st March 2021 convictions ended a long-running unlawful prescription drug billing conspiracy.  Escalona also noted that these convictions add to the total of accused persons who have prior admitted guilty. U.S. Attorney thanked the prosecutors and their law enforcement partners for their constant and persistent efforts in bringing these accused people to justice.  Escalona concluded his statement by specifically thanking the jury for their time and service.

Jessica Linton and John Gladden took part in a conspiracy to cause the pharmacy they were hired at to charge for prescription drugs that were medically unnecessary.  Jessica Linton worked as the individual overseeing the billing for the medications Global made, promoted, and traded; John Gladden worked as a district manager who oversaw a team of salespersons.  The conspiracy involved instructing workers to receive medically unnecessary medications for themselves, friend, and family members, changing prescriptions to add non-prescribed medications, automatically completing prescriptions irrespective of patient need, regularly discounting and waiving co-pays to persuade patients to get and retain medically unnecessary medications, and charging for medication without patients’ knowledge and consent. Once prescription medication administrators tried to look into this conduct, schemers avoided and interfered with those efforts, such as by giving fake information in reply to audits and channeling their billing via affiliated pharmacies.  The conspiracy aimed several health insurance plans, like the pharmacy’s Blue Cross Blue Shield of Alabama program, and plans giving health insurance to the disabled, elderly, military members, and veterans—TRICARE, Medicare, and CHAMPVA, among others.

Evidence revealed that the conspiracy led to pharmacy benefit managers’ reimbursing Global about 50 million U.S. dollars in claims in a period of two years.  During this duration, prescribers who were either reimbursed cash to direct prescriptions or whose spouses worked as salespersons at Global directed more than 13.3 million U.S. dollars in Global prescriptions. Besides, Global was reimbursed more than 8.4 million U.S. dollars for prescriptions acquired by Global workers.  For example, in August 2014, a health provider, who was reimbursed cash to direct Global prescriptions, directed a prescription for more than one pound of compound cream directed to cure yeast, athlete’s foot, ringworm, or fungus for a Global worker who was not a patient of that prescriber.  Global was reimbursed more than 30,000 U.S. dollars for that tube of cream. The health provider and worker guilty before trial.

The maximum sentence for a scheme to execute fraud health care and mail fraud is twenty years in prison and a 250,000 U.S. dollar fine. The maximum sentence for health care fraud is ten years in prison and a 250,000 U.S. dollar fine. The maximum punishment for mail fraud is twenty years in prison and a 250,000 U.S. dollar fine. The punishment for aggravated identity theft is an extra 2 years in prison.

The Internal Revenue Service-Criminal Investigation, the Federal Bureau of Investigation, the Defense Criminal Investigative Service, the U.S. Health & Human Services Department – Office of Inspector General and United States Postal Service conducted the case’s investigation.  United States Assistant Attorney J.B. Ward, United States Assistant Attorney Edward Canter, and the United States Assistant Attorney Don Long conducted the case’s prosecution.  The Veteran Affairs – Office of Inspector General, Criminal Investigations Division offered valuable support during the investigation.

Breaking the Controlled Substance Act, the False Claim Statute, and the Anti-Kickback Act is severely confined by the law. Besides, conspiracy to commit health care fraud like deceiving taxpayer-funded health care projects, for instance, Medicare, TRICARE, or Medicaid programs, is a severe offense. Anyone who performs these crimes breaks the law and is severely fined or disciplined if found legally responsible for the allegations. When indicted for these crimes, one should look for the perfect legal assistance or representation to defend and pursue your rights. One can hire our competent team of the best defense and criminal attorneys if in need of extremely remarkable legal assistance and representation, which will win one desirable result for an issue. Health Care Fraud Group consists of a qualified team of lawyers with tremendous skills in tackling Health Care Fraud-associated matters linked to the Federal Health Care System; they are incredibly informed about civil and federal cases. The attorneys are quite famous throughout the nation due to their outstanding and notable work and proficiency when handling health care fraud investigations and matters. Our attorneys are fully fitted out with earlier knowledge of every phase of Health Care fraud protection, medical, and legal matters.

Our offices are functional 24/7, and we are fully prepared and set to begin your protection instantly. We issue a brief and safe assessment of your matter and work fast to collect, get, and bring together the necessary and vital particulars regarding your case in the government’s inquiries. Once you employ us, we will assist you, and your colleagues come up with the correct and best verdict. Our extremely skillful team of attorneys will help and direct you when needed in anything you may want to distinguish and additional train your colleagues to excellently help in your criminal defense. This is because there are numerous vital mistakes you must avoid when facing health care fraud inquiries.

Besides, we will give you and your team with full legal assistance and defense in matters and investigations that you are indicted with and even those in other firms or institutions that cover the Internal Revenue Service and the Federal Bureau of Investigation, and inquiries and cases that are under the jurisdiction of the CMS, DOJ, DHHS, OIG, and DEA. Further, we will inquire about potential health care fraud and assist in keeping you and your career safe. Our highly qualified attorneys at the HCFG are conversant and clearly understand the need to prove innocence after the accusation of any crime. For any legal representation, advice, or support you may need, contact us at 888-402-4054.

Schedule a Confidential Initial Compliance Assessment with Our Federal Health Care Group