Two former associates of a Coshocton pharmacist have been sentenced to prison in a health care fraud scheme alleged to have taken between $1 million and $2.5 million from state, federal, and private medical insurance companies through fraudulent billing practices.
The defendants were sentenced yesterday in United States District Court in Akron.
“These sentences and fines show that the intentional defrauding of taxpayer dollars through healthcare fraud will not be tolerated,” Ohio Attorney General Mike DeWine said. “My office will continue to collaborate with state, federal, and local authorities to root out fraud and protect both patients and taxpayers.”
Douglas Bolden and James Ireland, both of Zanesville, were employed by Three Rivers Infusion and Pharmacy Specialists, owned by co-defendant Barbara Elise Miller. The company purported to offer medical supplies and home health services, but an investigation found that the defendants, led by Miller, 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.
Bolden was sentenced to two months in prison, followed by six months of electronically monitored home detention and then a three-year period of supervised release. He will pay a fine of $131,043.75. He pleaded guilty in February to one count of Obstruction of an Official Proceeding, one count of Obstruction of a Criminal Investigation of Health Care Offenses, and one count of Conspiracy to Obstruct a Criminal Investigation of Health Care Offenses. As part of his plea agreement Bolden voluntarily surrendered his pharmacy license.
Ireland was sentenced to two months in prison, followed by six months of electronically monitored home detention and then a one-year period of supervised release. He was fined $16,933.63. He pleaded guilty in June to one count of Misprision of a Felony. Ireland was an insurance verifier for both companies.
Both defendants’ fines will be applied to the joint restitution owed by Miller, whose fine and restitution will be assessed at her sentencing in December. Both defendants will surrender to authorities on November 12, 2013.
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.