An Oklahoma pharmacist faces up to 20 years in a federal prison and a $500,000 fine after pleading guilty to two counts of felony health care fraud. The 37-year-old man was indicted by a federal grand jury in March for filing false Medicare and Medicaid claims, and Oklahoma prosecutors announced in April that he had been charged with 40 counts of insurance fraud. The man’s guilty pleas were entered as part of a negotiated agreement with prosecutors.
The man is said to have made almost $1.1 million by billing Medicare, Medicaid and Oklahoma City-based SoonerCare for medicine that had never been prescribed by a physician for patients. The terms of his plea agreement require him to forfeit real estate in Greer County and pay restitution of $753,000 to Medicare and $338,000 to Medicaid. If he had been convicted at trial, the man could have been sentenced to 10 years in prison and ordered to pay a $250,000 fine for each of the 40 counts he faced.
Oklahoma Attorney General Mike Hunter said in a press statement that his office takes health care fraud extremely seriously because it affects the state’s most vulnerable residents and costs taxpayers millions of dollars each year. The man is expected to be sentenced later in the year.
Prosecutors often charge defendants with multiple counts in cases involving white-collar crimes to give themselves a strong position from which to begin plea negotiations. This position is usually bolstered by the evidence like documents that are difficult to refute. Criminal defense attorneys with experience in this area may anticipate this strategy and advise their clients not to be alarmed by it. Attorneys may also point out that prosecutors tend to avoid court if they can when their cases are complex and the victims are corporations or government agencies.
Source: Insurance Journal, Oklahoma Pharmacist Pleads Guilty to Fraud; Agrees to Pay $1M Restitution, Staff report, Aug. 14, 2019