Fraud related to health care has become a rampant problem, largely due to taxpayer-funded plans like Medicare and Medicaid. Privately run insurance companies have a tendency to be much stingier than either of the government health care plans and will contest whatever they feel is necessary or superfluous. While many Medicare drug programs utilize private insurance companies to pay for medications, Medicare has a tendency to rubber-stamp laboratory tests and procedures, some of which may not be necessary.
For the record, when a doctor orders unnecessary tests for the purpose of driving up a patient’s health insurance, that constitutes medical malpractice. In addition, a patient who blows the whistle on a doctor who is committing this form of fraud is able to initiate what’s called a qui tam action and whatever money is recovered from the fraud, they are eligible to receive anywhere from 15-30%. Since fraudsters are liable for up to 300% of the money they steal, this can potentially end up being a large sum of money.
It’s also a crime for which there are serious criminal penalties as Stephan Chalker discovered after being convicted of one count of conspiracy and two counts of committing substantive health care fraud. According to the evidence presented by prosecutors, Chalker engaged in a scheme to defraud Medicare, TRICARE, and Medicaid over a two-year period between 2014 and 2016.
The Case Against Stephen Chalker
Prosecutors claimed that Chalker submitted fraudulent claims for compounded drugs and other prescriptions that they say were unnecessary or no one ever asked for. Chalker was then the head pharmacist at Pop’s Pharmacy which is no longer in business. According to the charges, Chalker submitting thousands of dollars in claims for a scar cream that patients never ordered. In some cases, the patients never received the cream.
Because Medicare and Medicaid applicants tend not to receive billing information, it’s very easy to dupe patients into paying for medication that they sometimes don’t even receive. Chalker’s scheme was based on a telemarketing/telemedicine fraud that managed to steal nearly $5 million from taxpayers and drain health insurance resources that are meant for the elderly and disabled.
The prosecution identified two other defendants who were also charged in the conspiracy and pleaded guilty to related charges.
Defending Fraud Cases in the Courtroom
Chalker was the victim of a major crackdown against Medicare and Medicaid fraud. It was clear that the prosecution wanted to make an example out of him to discourage other potential fraudsters from attempting a similar scheme. While it’s important to reduce fraud and waste within the system, it’s also important to maintain a fair and impartial justice system that hands out reasonable sentences for the crime. Chalker has not been sentenced yet but could face a mandatory minimum on the federal fraud charge. Indeed, half the alphabet was expended bringing together various government agency to prosecute Chalker.
Talk to a West Palm Beach Fraud Defense Attorney
If you have been charged with fraud by the federal or state government, felony convictions can land you real jail time. Talk to a defense attorney who is experienced in handling fraud cases. The Skier Law Firm P.A. in West Palm Beach has successfully managed several fraud cases getting charges reduced for our clients and dropped when that was appropriate. We have experience bring cases to trial as well. Give us a call or contact us online to set up an appointment.