North Carolina Pharmacist Sentenced to Prison For Medicare and Medicaid Fraud
GREENVILLE – The United States Attorney’s Office for the Eastern District of North Carolina announced that yesterday in federal court, JUSTIN LAWRENCE DANIEL, 35, of Fayetteville, North Carolina, was sentenced to 12 months and a day in federal prison and 3 years of supervised release following his prior guilty plea to Health Care Fraud Conspiracy. DANIEL was also ordered to make restitution of $1,961,176.56 to the Medicare program and $479,923.50 to the North Carolina Medicaid program.
United States Attorney Robert J. Higdon, Jr. stated, “This was a case of a corrupt pharmacist who mixed and sold non-covered pain cremes to the public, but who billed federal taxpayers millions for expensive pain pills through the Medicare and Medicaid programs. I am happy to report not only that this pharmacist will be reporting to federal prison as punishment, but more importantly, that he has surrendered his pharmacy license and has already paid back $2 Million of the money he stole. Mr. Daniels will never again be in a position to defraud patients, or taxpayers, using his pharmacy license. I wish to congratulate our state and federal law enforcement partners on the outcome of this important conviction and sentencing.”
North Carolina Attorney General Josh Stein said, “Cheating Medicaid wastes tax dollars, and it’s unacceptable. My office will continue our work to protect taxpayers and hold the healthcare providers who commit fraud accountable.”
The Criminal Information to which DANIEL pleaded guilty, as well as information provided at the sentencing hearing, provided that between 2011 and 2015, DANIEL owned and operated Old Main Pharmacy, Inc. (“Old Main”) located in Pembroke and Rowland, North Carolina. During that time period, DANIEL directed his staff to fraudulently bill the Medicare program and the North Carolina Medicaid Program for Ketoprofen extended release capsules that his pharmacy did not use when creating a compounded pain-relief cream sold by Old Main.
In addition to being sentenced to federal prison and serving a term of supervised release, DANIEL surrendered his North Carolina pharmacist’s license. Prior to sentencing, DANIEL paid $2,000,000 to the court in anticipation of the sizable restitution judgment.
The investigation of this case was conducted by agents of the Medicaid Investigations Division of the North Carolina Attorney General’s Office; the United States Department of Health and Human Services Office of the Inspector General; with the assistance of the North Carolina Board of Pharmacy. The investigation and prosecution of this matter was handled in a partnership between the United States Attorney’s Office for the Eastern District of North Carolina and the Medicaid Investigations Division of the North Carolina Attorney General’s Office. Special Assistant United States Attorney John Parris of the Medicaid Investigations Division of the North Carolina Attorney General’s Office, and Assistant United States Attorney William M. Gilmore of the Economic Crimes Division of the U.S. Attorney’s Office, each represented the United States.
If you suspect Medicare fraud please report it by phone at 1-800-447-8477 (1-800-HHS- TIPS), or E-Mail at HHSTips@oig.hhs.gov. To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.