Fraud Along the Mississippi

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Stethoscope on 100 dollar bills symbolizing financial surveillance

The role of medical professionals is to provide the best medical care possible to patients without bias. In today’s fraud case, it wasn’t bias that prevented the doctors and nurses from performing their oathbound duty, rather it was their own greed.

Tennessee-based Dr. Thomas Sturdavant, and Freda Covington, R.N., from Mississippi, were sentenced earlier this year for their roles in a conspiracy to commit health care fraud. They plotted to defraud healthcare beneficiaries alongside their co-defendant Dr. Shahjahan Sultan.

Dr. Sultan entered into an illegal contract with a pharmacy in Jackson County, Mississippi in 2014. The pharmacy asked Sultan to prescribe expensive compound medications in exchange for 35 percent of the healthcare reimbursements for the prescriptions. (I’m starting to believe the conspiracy theorists when they say ‘they’re all trying to scam you.’)

Sultan then approached and offered Sturdavant $900,000 to join him in prescribing medically unnecessary and expensive compound medications. Strudavant performed telemedicine services for patients and prescribed the compounded medication. He wrote over fifty prescriptions for patients he never physically examined. (You don’t have to examine someone to create an imaginary problem.)

Covington used her role as a registered nurse to identify people who had insurance that covered the expensive compound medication. She would approach people at gas stations and other public settings to perform physical examinations and lead them to believe that they were in need of medication. (If a stranger tried to approach and examine me, especially at a gas station, my first instinct would be to run away quickly. It would not be to write them a check for a prescription.)

Another nurse, Fallon Page was also charged with mail fraud for her involvement in the conspiracy. Page mailed the compound medications to patients on behalf of the pharmacy knowing that they were medically unnecessary. She was also paid $100 by Sultan for every person with health insurance she referred to him.

Strudavant was sentenced to two years in federal prison and three years of supervised release for committing health care fraud. He must also pay a money judgement of $160,000 and $1,628,409 in restitution payments.

Sultan was also sentenced to two years in prison for his role in the health care fraud scheme. He was ordered to pay $4,102,634.65 to Express Scripts for Tricare claims, $582,280.79 to CVS Caremark and $115,611.03 to Catamaran. Sultan additionally owes a money judgement of $2.3 million. (Seems like the cost of the crime wasn’t worth the short-term reward.)

Today’s Fraud of the Day comes from a Department of Justice press release, “Doctor and Nurse Sentenced for Conspiracy to Commit Health Care Fraud in Compounding Pharmacy Scheme,” on June 24, 2020.

Jackson, Miss. –   Dr. Thomas Edward Sturdavant, M.D., 56, of Cordova Tennessee, was sentenced Monday and Freda Cal Covington, RN, 55, of Hattiesburg, was sentenced today by Senior U.S. District Judge Keith Starrett for their roles in a conspiracy to commit health care fraud, announced U.S. Attorney Mike Hurst, Special Agent in Charge Michelle Sutphin of the Federal Bureau of Investigation (“FBI”) in Mississippi, and Special Agent in Charge Cyndy Bruce of the U.S. Department of Defense’s Criminal Investigative Service’s (“DCIS”) Southeast Field Office.

Sturdavant was sentenced to 24 months in federal prison, followed by three years of supervised release, and ordered to pay a monetary judgment of $160,000, along with restitution in the amount of $1,628,409.  Covington was sentenced to 18 months in prison, followed by three years of supervised release. Co-defendant Dr. Shahjahan Sultan was sentenced on June 16, 2020 to 48 months in prison for his involvement in the conspiracy.

 

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.