Former pharmacist guilty of health care fraud, drug adulteration

Woman took between $1 million and $2.5 million from insurance companies through fraudulent billing practices.
Norwalk Reflector Staff
Oct 3, 2013

 

Ohio Attorney General Mike DeWine announced Wednesday that a former Coshocton pharmacist has pleaded guilty to federal charges alleging that she took between $1 million and $2.5 million from state, federal, and private medical insurance companies through fraudulent billing practices.

Barbara Elise Miller pleaded guilty yesterday to five counts of Health Care Fraud and one count of Adulteration of Drugs. The charges stem from Miller's time as the owner and operator of Coshocton's Three Rivers Infusion and Pharmacy Specialists, a medical infusion supply company which also provided home health services and medical supplies. 

"This plea came as the result of a lot of hard work between state and federal agencies," DeWine said. "Crimes like this contribute to the rise in heath care costs, and those who engage in health care fraud will not get away with it."

Between 2003 and 2009, investigators found that Miller knowingly and willfully executed a scheme to defraud health care benefit programs such as Ohio Medicaid, Medical Mutual of Ohio (MMOH), Anthem Blue Cross/Blue Shield of Ohio, TriCare, and Medicare.

The investigation found that Miller filed more than a million dollars worth of claims for services using a false provider name, overstated the amount of nursing time needed to provide certain injections, and made fraudulent claims regarding the dosage and frequency of which certain drugs were dispensed.

Miller also pleaded guilty to altering the purity, quality, and strength of the drug Kineret, which is used to reduce the pain and swelling associated with moderate to severe Rheumatoid Arthritis.

Miller will be sentenced in December.

The case was prosecuted by attorneys with the Ohio Attorney General DeWine's Health Care Fraud Section and the office of United States Attorney for the Northern District of Ohio Steven Dettelbach.  The case was investigated by Attorney General DeWine's Medicaid Fraud Control Unit, the Ohio Department of Insurance, the United States Department of Health and Human Services, Office of the Inspector General, and the Federal Bureau of Investigation.