U.S. government programs that assist low-income Americans with health care costs are a magnet for unscrupulous thieves and fraudsters—many of them licensed health care professionals. It’s difficult to compute solid statistics for the annual losses to Medicare and Medicaid fraud, but some sophisticated researchers, including the FBI, have estimated that it can be as low as three percent or as high as ten percent of spending by these programs. Unfortunately, North Carolina has its fair share of criminals who devise elaborate schemes to enrich themselves at taxpayers’ cost.
Last October, North Carolina pharmacist Justin Lawrence Daniel pleaded guilty to health care fraud conspiracy to the tune of nearly $2.5 million. AP reported that Daniel was sentenced to 12 months and a day in federal prison and three years of supervised release for his fraudulently billing to Medicare program and the North Carolina Medicaid Program. In addition, Daniel was ordered to make restitution of nearly $2.5 million, and to surrender his pharmacist’s license.
According to the U.S. Attorney’s Office Eastern District of North Carolina, Daniel “owned and operated Old Main Pharmacy, Inc. (“Old Main”) located in Pembroke and Rowland, North Carolina. … During that time period [he] directed his staff to fraudulently bill the Medicare program and the North Carolina Medicaid Program for Ketoprofen extended-release capsules that his pharmacy did not use when creating a compounded pain-relief cream sold by Old Main.” In other words, the pharmacist was compounding a pain-relief cream, and billing for medications he claimed to be using as ingredients, when he did not in fact use in making the cream.
U.S. Attorney Robert J. Higdon, Jr. said, “This was a case of a corrupt pharmacist who mixed and sold non-covered pain cremes to the public, but who billed federal taxpayers millions for expensive pain pills through the Medicare and Medicaid programs. I am happy to report not only that this pharmacist will be reporting to federal prison as punishment, but more importantly, that he has surrendered his pharmacy license and has already paid back $2 Million of the money he stole. Mr. Daniels will never again be in a position to defraud patients, or taxpayers, using his pharmacy license.”
Richard Manger, principal of Manger Law Firm, has extensive experience in litigation and settlements, with a focus on workers’ compensation and personal injury law. We are proud of the strong relationships of loyalty and trust we develop with our clients. We go above and beyond to achieve the best possible outcome in your case. You can contact Richard Manger via email at ram@mangerlaw.com, or by calling (336) 882-2000.
