VINCheck® users can now utilize any camera-ready device to upload a photo of a VIN. Check out the enhancement >

National Insurance Crime Bureau

Mobile Doctor Sentenced to Four Years for Role in Major Compounding Pharmacy Fraud Conspiracy

The United States Attorney’s Office, Northern District of Alabama, October 26, 2021

Tuscaloosa, Ala. – A Mobile-area doctor was sentenced today for her role in a major compounding pharmacy fraud scheme, announced U.S. Attorney Prim F. Escalona, Federal Bureau of Investigation Special Agent in Charge Johnnie Sharp, Jr., U.S. Department of Health and Human Services, Office of Inspector General, Special Agent in Charge Derrick L. Jackson, Defense Criminal Investigative Service Special Agent in Charge Cynthia Bruce, U.S. Postal Inspection Service Acting Inspector-in-Charge, Houston Division, Dana Carter, and IRS Criminal Investigations Atlanta Field Office Special Agent in Charge James Dorsey.

Chief U.S. District Judge L. Scott Coogler sentenced Dr. Michelle Martine Jackson, 55, of Fairhope, Alabama, to four years in prison.  Jackson was also ordered to pay forfeiture of $53,000 and restitution of $3,920,584.84.  Jackson pleaded guilty in June to conspiracy to commit health care fraud.

“This defendant abused the power of her prescription pad, breached the public’s trust, and cost insurers millions of dollars as a result,” U.S. Attorney Escalona said.  “Her sentence is a reminder that health care fraud is a serious crime and carries serious consequences.”

Global, a pharmacy based in Haleyville, Alabama, has been the subject of a large-scale health care fraud investigation that has resulted in nearly thirty convictions to date.  The Global health care fraud conspiracy involved Global managers directing Global employees to get medically unnecessary drugs for themselves, family members, and friends, changing prescriptions to add non-prescribed drugs because insurance would pay for them, automatically refilling prescriptions regardless of patient need, routinely waiving and discounting co-pays to induce patients to get and keep medically unnecessary drugs, and billing for drugs without patients’ knowledge.  When prescription drug administrators attempted to police this conduct, the conspirators hid their fraud and obstructed detection efforts—including by lying to auditors and diverting their billing through affiliated pharmacies.  The scheme targeted multiple health insurance plans, including the pharmacy’s Blue Cross Blue Shield of Alabama plan, as well as plans providing health insurance to the elderly, disabled, members of the military, and veterans—Medicare, TRICARE, and CHAMPVA, among others.

As part of the scheme, certain Global sales reps paid kickbacks to medical prescribers in exchange for writing prescriptions.  Michelle Jackson was one of those prescribers.  As part of her plea agreement, Jackson admitted that she had received cash kickbacks for writing prescriptions.  She admitted that she wrote prescriptions for Global drugs that were not medically necessary, including for the sales rep’s family and friends, individuals Jackson had never treated, and family of Jackson’s staff.  For example, Jackson wrote the sales rep’s pregnant daughter prescriptions for a drug that was contraindicated for pregnant women.  Jackson also pre-signed blank prescription forms to enable co-conspirators to issue prescriptions under her name simply by checking boxes on the prescription forms.

The FBI, HHS-OIG, DCIS, USPIS, and IRS-CI investigated the cases.  Assistant U.S. Attorneys J.B. Ward, Edward Canter, and Don Long prosecuted the case.  The Veteran Affairs Office of Inspector General Criminal Investigations Division aided in the investigation.

News article: https://www.justice.gov/usao-ndal/pr/mobile-doctor-sentenced-four-years-role-major-compounding-pharmacy-fraud-conspiracy