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TX Physician and Two Pharmacists Charged for $170M OWCP Fraud Scheme

September 28, 2023 - WorkCompWire

Houston, TX – A 13-count indictment was recently unsealed charging two pharmacists and a physician for their roles in a multimillion-dollar health care fraud, kickback, and money laundering scheme.

According to court documents, Shalondria Simpson of Houston, is a pharmacist who owned and operated two pharmacies in Houston: Advance Pharmacy (Advance) and TruCare Pharmacy (TruCare). Simpson’s twin sister, physician Lashondria Simpson-Camp of Allen, Texas, allegedly referred prescriptions to Advance and TruCare in exchange for illegal kickbacks and bribes. Shayla Bryant of Houston, was a pharmacist and Advance and TruCare’s business manager.

Between 2016 and 2022, Simpson, Simpson-Camp, and Bryant allegedly conspired with others to submit false and fraudulent claims to the Department of Labor’s Office of Workers’ Compensation Program (DOL-OWCP), which administered workers’ compensation benefits on behalf of the Federal Employee’s Compensation Act (FECA), for high reimbursing drugs that were often medically unnecessary and induced by kickbacks and bribes. Further, Simpson, Simpson-Camp, Bryant, and others allegedly conspired to pay and receive these kickbacks. Simpson and Bryan allegedly paid illegal kickbacks and bribes, often through shell entities or in cash, directly to physicians like Simpson-Camp, a clinic owner, a medical assistant, and other marketers. In total, Simpson’s pharmacies allegedly submitted approximately $170 million in fraudulent claims to FECA through DOL-OWCP.

To conceal the scheme and disguise its proceeds, Simpson also allegedly conspired to launder the proceeds of the criminal activity through financial transactions greater than $10,000. According to the indictment, after learning of the investigation, Simpson attempted to cover her tracks by converting criminal proceeds to cash, and transferring funds among over ten bank accounts and a cryptocurrency wallet. She also allegedly solicited others’ help in liquidating assets and concealing her ownership and control of those assets.

The indictment charges Simpson, Simpson-Camp, and Bryant with one count of conspiracy to defraud the United States and pay and receive health care kickbacks and one count of conspiracy to commit health care fraud. Simpson is also charged with five counts of paying health care kickbacks, one of which also charges Bryant. The indictment further charges Simpson with conspiracy to launder monetary instruments and five counts of money laundering. If convicted, Simpson, Simpson-Camp, and Bryant each face a maximum penalty of five years in prison for conspiracy to defraud the United States and pay and receive health care kickbacks, and 10 years in prison for conspiracy to commit healthcare fraud. Simpson and Bryant each face a maximum penalty of 10 years in prison for each count of paying health care kickbacks. Simpson faces a maximum penalty of 20 years in prison for conspiracy to launder money instruments and 10 years for each count of money laundering.

Acting Assistant Attorney General Nicole M. Argentieri of the Justice Department’s Criminal Division, U.S. Attorney Alamdar S. Hamdani for the Southern District of Texas, Special Agent in Charge Jonathan Ulrich of the U.S. Postal Service Office of Inspector General (USPS-OIG), Acting Special Agent in Charge Casey Howard of the Department of Labor Office of Inspector General (DOL-OIG), Acting Special Agent in Charge David L. Martinez of the FBI Houston Field Office, and Special Agent in Charge Kris Raper of the Department of Veterans Affairs Office of Inspector General (VA-OIG) South Central Field Office made the announcement.

The USPS-OIG, DOL-OIG, FBI, and VA-OIG are investigating the case.

Trial Attorneys Devon Helfmeyer and Andrew Tamayo of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Brandon Fyffe for the Southern District of Texas are prosecuting the case.

An indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

Source: US Attorney’s Office

Filed Under: Industry News, Top Stories, Workers' Compensation

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