LOUISVILLE, KY – A Louisville pharmacist who fraudulently billed healthcare benefit plans for $188,157 in unfilled prescriptions will serve 9 months in prison and 2 years of supervised release after pleading guilty in federal court.
The U.S. Department of Labor’s Employee Benefits Security Administration found that – between November 2015 and December 2018 – Gary Green of Louisville participated in a fraudulent scheme to bill Anthem and other healthcare benefit programs for pain cream prescriptions that were never filled. Green submitted fraudulent billings using national provider identifier numbers of two physicians without their authorization. As a result, Anthem and other healthcare benefit programs paid $188,157 relating to the fraudulent billings.
“Knowingly committing healthcare fraud victimizes insurance companies and hardworking employees,” said Employee Benefits Security Administration Regional Director L. Joe Rivers in Cincinnati, Ohio. “Fraudulently inflating healthcare bills for unnecessary or non-existent treatments raises the cost others pay for health insurance. The U.S. Department of Labor remains committed to preventing benefits abuse, and will hold anyone found guilty of fraud accountable.”
Investigators also determined Green deposited proceeds from the fraudulently billed prescriptions into his business bank account. He then transferred the proceeds to his personal bank account knowing that the funds involved in the financial transaction represented the proceeds of a healthcare fraud.
On Nov. 18, the U.S. District Court for the Western District of Kentucky sentenced Green to 9 months in prison and 2 years of supervised release. The court also ordered him to pay $188,157 in restitution. The court’s action follows a January 2020 guilty plea by Green to two counts of false or fraudulent material omissions, one count of healthcare fraud valued at $188,157 and one count of money laundering.
Employers and workers can reach EBSA toll-free at 866-444-3272 for help with problems related to private sector retirement and health plans. Learn more about EBSA.