Health care fraud is increasingly common in the United States as doctors attempt to submit false claims in order to receive payment. However, these schemes are illegal and can result in serious penalties. A Pennsylvania pharmacist faces federal charges for his alleged role in a scheme to defraud insurance companies.
The Old Forge man could face fines and imprisonment after allegedly defrauding Medicaid and Blue Cross of Northeastern Pennsylvania. The Federal Bureau of Investigation claims that the pharmacist submitting pharmacy claims for prescriptions that were never dispensed. This scheme lasted for a period of six years -- from 2007 to 2013.
The man pleaded guilty to health care fraud and will be required to pay back the insurance companies for the losses they sustained. Because this type of fraud is a federal offense, the man could also face prison time and probation.
Fraud is a serious crime, but a solid defense may possibly help reduce charges and subsequent penalties. For this case, the pharmacists can expect to face no more than 10 years in prison, probation and fines. However, the court can adjust the penalty based on many factors, such as the man's criminal history, the seriousness of the crime, the circumstances under which it occurred and the need to protect the public.
Based on the facts of the case, the man is not dangerous. He did not physically harm anyone. He simply found ways to get more money than he should have. Although his actions should not be condoned, sometimes greed can cause a person to do things that he or she normally would not do.
Source: The United States Department of Justice, "Old Forge Pharmacist Pleads Guilty To Health Care Fraud" No author given, Apr. 25, 2014