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Training Programs

Healthcare-10
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Employee training programs are essential to a company’s success. For employees, training programs provide the opportunity to learn new skills, improve existing ones, and build their confidence. For employers, training programs lead to a more skilled and effective workforce, which can help the company achieve its goals. Townsend Pharmacy thrived because of their training program. The employees learned some concrete skills as to how processes prescritpions reimbursements from Medicare and Medicaid. But the ultimate goal of the training program at Townsend Pharmacy was to fraud the American taxpayer.  And since the prescriptions were bogus, the owner, James Craig Bell,  made an extra $4 million in fraudulent Medicare and Medicaid reimbursements.

Beginning as early as 2006 through July 2017, James Craig Bell, owner of Townsend’s Pharmacy, Bell trained employee, Melisha Oxendine West and other employees on how to bill health care benefit plans for drugs that were not authorized or dispensed. Included in Bell’s training was how 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. Advanced opportunities provide more earning power! West began independently running the pharmacy’s operations while Bell continued to knowingly profit from the fraudulent billing practices. 

Training objectives seemed to be achieved until a whistleblower questioned the practices of Townsends Pharmacy. Both Bell and West were sentenced to two years in prison for health care fraud.

Shout out to Bronson Lowery, the whistleblower who brought this fraud to light. would have continued if Lowery hadn’t interrupted this scheme.

Today’s Fraud of The Day is based on article “NC pharmacy owner sentenced to prison for $4 million in fraudulent Medicare, Medicaid billing” published by WRAL News on August 11, 2023

The owner of a Robeson County pharmacy was sentenced Thursday to two years in prison for billing the government for medication patients never received.

According to a news release from the U.S. Attorney’s Office, James Craig Bell, 63, owned Townsend’s Pharmacy and fraudulently billed Medicare and Medicaid between 2006 and 2017. Bell pleaded guilty to conspiracy to commit health care fraud in October.

“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,” said U.S. Attorney Michael Easley.

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