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, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.