North Carolina pharmacy owner, employee sentenced to prison for roles in fraudulent health care scheme

Published 7:18 am Wednesday, August 23, 2023

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The U.S. Department of Justice, Eastern District of North Carolina, has reported on the sentencing of a pharmacy owner and his employee for their roles in a fraudulent health care fraud scheme.

According to a news release from the U.S. Attorney’s Office, James Craig Bell, 63, was sentenced August 10, 2023 to 24 months for conspiracy to commit health care fraud in connection with a scheme through his pharmacy in Robeson County, which had operated under the name Townsend’s Pharmacy. Bell previously pleaded guilty to the charge in October 2022. Melisha Oxendine West, 51, Bell’s codefendant and former employee, was sentenced last month following her guilty plea to 24 months imprisonment followed by three years of supervised release in connection with the same scheme.

“People who steal taxpayer-funded programs intended to provide healthcare to the needy will be investigated and prosecuted,” said U.S. Attorney for the Eastern District of North Carolina Michael Easley. “For over a decade, Bell and his pharmacy fraudulently billed Medicare and Medicaid over $4 million for medicine he never actually gave to patients. That money should have gone to getting vital medications to those in need.”

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According to the release, beginning as early as 2006 through July 2017, Bell, acting through Townsend’s Pharmacy, billed Medicare, Medicaid and various private health plans for prescription drugs that were never actually dispensed by the pharmacy. “Bell had trained West and other employees on how to bill health care benefit plans for drugs that were not authorized or dispensed. Bell also trained employees to falsely reauthorize a previously existing prescription from a licensed medical professional, and, how to falsely bill health care benefit programs as though a drug had been dispensed,” stated the release. “West began independently running the pharmacy’s operations while Bell continued to knowingly profit from the fraudulent billing practices.”

The fraud scheme cost Medicare and North Carolina Medicaid more than $4 million in total in fraudulent billings by conservative estimates, stated the release.

“When providers submit false claims to Medicare and Medicaid, they take valuable, taxpayer-funded resources away from patients,” said Tamala E. Miles, special agent in charge at the Department of Health and Human Services, Office of Inspector General (HHS-OIG). “HHS-OIG is proud to work with our partners to hold accountable those who attempt to illegitimately profit off of federal health care programs.”

Easley made the announcement after U.S. District Judge Louise W. Flanagan announced the sentence.  The United States Department of Health and Human Services Office of the Inspector General is investigating the case and Assistant U.S. Attorney David G. Beraka is prosecuting.