WI: Janesville Pharmacist Charged with Health Care Fraud & Identity Theft
Madison, Wis. – John W. Vaudreuil, United States Attorney for the Western District of Wisconsin, announced that Mark Johnson, 55, Janesville, Wis., was arrested without incident in Janesville, by agents from the U.S. Department of Health and Human Services and the U.S. Postal Inspection Service, with assistance from the Janesville Police Department. Johnson will make his initial appearance in federal court later today.
Johnson was charged in a 46-count indictment returned by a grand jury Wednesday in Madison. The indictment was unsealed today following his arrest. The indictment charges Johnson with health care fraud, making false statements in a health care fraud audit, and identity theft. Each of the 39 health care fraud charges carries a maximum penalty of 10 years in federal prison; the false statements charge carries a maximum penalty of five years in federal prison; and the six identity theft charges each carries a mandatory penalty of two years in federal prison.
The indictment alleges that Johnson devised a scheme to defraud Medicare and Medicaid from approximately January 2008 to March 2014. During this time period, Johnson was a licensed pharmacist, and the owner and president of Kealey Pharmacy and Home Care, Inc., a pharmacy located at 21 South Jackson Street, in Janesville. Kealey Pharmacy was a retail pharmacy providing, among other things, prescription drugs to customers. Kealey Pharmacy was reimbursed for these prescriptions in a number of ways, including reimbursement payments under Medicare and Medicaid.
The indictment alleges that Johnson submitted false and fraudulent claims to Medicare and Medicaid obtaining reimbursement for medication that was not, in fact, provided to beneficiaries. The indictment also alleges that Johnson created false prescription orders for medication and submitted claims for reimbursement for medication pursuant to these false prescription orders. The indictment alleges that Johnson caused the payment of approximately $1,000,000 by Medicare and Medicaid to him during the time period of the fraud.
The indictment also alleges that Johnson lied in August 2013 in his responses to an audit being conducted by the Wisconsin Department of Health Services of paid Medicaid claims for the period from January 2010 to December 31, 2011. Finally, the indictment charges that Johnson used the DEA number and National Provider Identifier of two physicians to create false and fictitious physician’s prescription orders to support the submission of false claims to Medicare and Medicaid.
U.S. Attorney Vaudreuil stated that today’s arrest and the indictment are the result of a lengthy investigation conducted by the U.S. Department of Health and Human Services, Office of Inspector General, and the U.S. Postal Inspection Service. Prosecution of this case is being handled by United States Attorney Vaudreuil and Assistant U.S. Attorney Meredith P. Duchemin.
You are advised that a charge is merely an accusation and that a defendant is presumed innocent until and unless proven guilty.
SOURCE: U.S.A.O. Western District of Wisconsin