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Fentress County pharmacist charged in multi-million dollar health care fraud scheme


Fentress County pharmacist charged in multi-million dollar health care fraud scheme

KNOXVILLE, Tenn. (WVLT) - A Fentress County pharmacist has been charged with several counts of health care fraud and aggravated identity theft.

According to the U.S. Attorney's Office for the Middle District of Tennessee, 48-year-old Philip Hall was a licensed pharmacist in Fentress County who was the owner, operator, and registered agent of Hall Family Pharmacy, Inc.

Hall was the pharmacist-in-charge at the location in Jamestown and one of the pharmacists at the Clarkrange location. According to an indictment, Hall submitted false claims to Medicare, Medicaid, TRICARE and Blue Cross Blue Shield from 2018 until at least May 2024 for prescriptions for drugs that were medically unnecessary, not actually dispensed, or were not ordered by a physician or other healthcare provider.

The indictment said the pharmacies lacked the inventory to even dispense these drugs in many cases.

In total, Hall submitted false claims to Medicare, Medicaid and TRICARE totaling more than $6 million, according to the indictment.

On many occasions, officials said Hall also used other people's identity without their authorization to get reimbursed for claims submitted to a health care benefit program. Hall personally profited from his participation in the scheme by receiving fraud proceeds for his personal use.

"We will always seek to protect taxpayer dollars from those who would take them fraudulently and illegally," said Acting United States Attorney Thomas J. Jaworski. "Seniors in our community need to know that Medicare will be protected from fraud and abuse."

Hall was charged with nine counts of health care fraud and six counts of aggravated identity theft. If convicted, Hall faces up to ten years in federal prison for each health care fraud count and two years for the aggravated identity theft counts.

Additionally, the United States is also asking for $6,524,585.44, which represents the proceeds of Hall's fraud scheme.

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