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For some people, living a minimalist lifestyle means having a happier life. This is not so for the owner of a pharmacy in Red Bud, Illinois and his wife. After the pharmacist was charged with healthcare fraud, his wife tried to minimize their connection with the scam by posting a very unintelligent comment about the case on their company’s very public Facebook page. They have since been forced to downsize significantly. (It looks like they’re going to have to downsize a bit in order to make the $620,000 restitution payment ordered by the judge.)

Today’s fraud article states that the pharmacist and former owner of a drug store in Red Bud purchased the business in October 2016. Within two months of opening his doors for business, he began defrauding Medicare, Medicaid and private insurance companies by submitting approximately 1,000 claims for non-existent prescriptions in the names of his wife, family members and some of his pharmacy customers. (The prescriptions were not ordered or signed off on by a licensed medical practitioner nor actually filled.) To maximize the amount of money he received from the insurers, he prescribed expensive drugs to treat conditions such as chronic pancreatitis, ulcerative colitis and malaria. (Because malaria must be common in Red Bud, Illinois.)

It was a pharmacist employed at the pharmacy who discovered the scam. After taking a call from a disgruntled customer who noticed a bill for expensive medications that were never received, the pharmacist quit her job and promptly called authorities to blow the whistle on her boss. A federal search warrant was executed at the pharmacy and the pharmacist agreed to cooperate in the investigation.

It wasn’t long before the pharmacist had to swallow a bitter pill and plead guilty to healthcare fraud. He accepted a plea deal that required him to repay the $620,000 stolen from Medicare, Medicaid and private insurers. In a post by the pharmacist’s wife on the same day that her husband pleaded guilty, she claimed that the charges against her husband were erroneous. (If you want to see exactly what she said, take a look at the article. Her attempt at minimizing her husband’s criminal activity at the pharmacy failed.)

The 30-year-old pharmacist and former owner of the Red Bud pharmacy was sentenced to 33 months in prison and two years of supervised release. Unfortunately, the pharmacist did not stick to his agreement to pay back the $620,000 prior to sentencing. (He only repaid $30,000 of that amount. Consequently, that didn’t bode well for the young pharmacist when the judge handed down his prison sentence.) Because the pharmacist did not accept responsibility for his criminal actions (and his wife’s Facebook post did not help with his image either) the young man will be living a very minimalist existence behind bars for the next couple of years.

Today’s “Fraud of the Day” is based on a Department of Justice press release entitled, “Former Pharmacy Owner Headed to prison for Bogus Claims to Health Insurers,” released on January 22, 2019.  

The pharmacist and former owner of Gibson’s Discount Drugs in Red Bud, Illinois, has been sentenced to 33 months in prison for engaging in a scheme to defraud federal health care benefit programs and private insurance companies. Steven P. Gibson, 30, pleaded guilty to federal charges back in August 2018.

Court records establish that Gibson purchased the pharmacy in October 2016 and began defrauding health insurers just two months later. From December 2016 to February 2018, Gibson submitted nearly 1,000 claims for “make believe” prescriptions under the names of his wife, his family members, and his pharmacy customers. To maximize his fraudulent gains, Gibson deliberately chose the most expensive drugs, such as Creon, a drug used to treat chronic pancreatitis, Pentasa, a drug used to treat ulcerative colitis, and hydroxychloroquine, a drug used to treat and prevent malaria. The fictitious prescriptions were not authorized by a licensed medical practitioner and were never actually filled. Gibson’s total take from Medicare, Medicaid, and private insurance companies exceeded $620,000 – money he has now been ordered to pay back in restitution.

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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.