Nurse Practitioner Pleads Guilty in Compounding Pharmacy Fraud Scheme

From:  News Release   6/15/18   GCN

WASHINGTON – A Mississippi-based nurse practitioner pleaded guilty for her role in a scheme to defraud health care benefit programs including TRICARE, the health care benefit program serving U.S. military, veterans and their respective family members.

Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, U.S. Attorney D. Michael Hurst Jr. of the Southern District of Mississippi, Special Agent in Charge Christopher Freeze of the FBI’s Jackson, Mississippi Field Division, Acting Special Agent in Charge Thomas J. Holloman III of IRS Criminal Investigation’s (IRS-CI) New Orleans Field Office and Special Agent in Charge John F. Khin of the Defense Criminal Investigative Service’s (DCIS) Southeast Field Office made the announcement.

Susan K. Perry, 58, of Grand Bay, Alabama, pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Keith Starrett of the Southern District of Mississippi. Perry is scheduled to be sentenced by Judge Starrett on Sept. 20. Perry was charged in a 13-count indictment and had been scheduled to begin trial on June 26.

As part of her plea, Perry admitted her role in a scheme to defraud health care benefit programs by prescribing medically unnecessary compounded medications to individuals who did not need the medications, sometimes without first examining those individuals. Perry admitted that she knew that Advantage Pharmacy, based in Hattiesburg, Mississippi, would submit claims for reimbursement to health care benefit programs, including TRICARE, for compounded medications based on the prescriptions she signed, and she further expected that the health care benefit programs would pay the claims. From approximately January 2014 through April 2015, health care benefit programs, including TRICARE, reimbursed Advantage Pharmacy approximately $1,375,692 based on the claims submitted by Advantage Pharmacy in connection with the compounded medications that Perry prescribed.

The FBI, IRS-CI, DCIS, the U.S. Department of Health and Human Services (HHS) Office of Inspector General, the Mississippi Bureau of Narcotics, and other government agencies investigated the case. Trial Attorneys Katherine Payerle and Jared Hasten of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Mary Helen Wall of the Southern District of Mississippi are prosecuting the case.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.