Medicaid Recipients Agree to Pay $130,000 to Resolve False Claims Act Allegations of Health Care Benefit Fraud
Jackson, Miss. – Dr. Shahjahan Sultan, M.D., 37 of Madison, was sentenced today by Senior U.S. District Judge Keith Starrett to 48 months in federal prison, followed by 3 years of supervised released, for conspiring to commit health care fraud, announced U.S. Attorney Mike Hurst, Special Agent in Charge Michelle Sutphin of the Federal Bureau of Investigation (“FBI”) in Mississippi, and Special Agent in Charge Cyndy Bruce of the Defense Criminal Investigative Service’s (“DCIS”) Southeast Field Office. Sultan was also ordered to pay restitution in the amount of $4,102,634.65 to Express Scripts (TRICARE), $582,280.79 to CVS Caremark and $115,611.03 to Catamaran. The Court further imposed a money judgment of more than $2.3 million.
In May 2014, Sultan entered into a contract with a pharmacy located in Jackson County, Mississippi. Pursuant to the contract, Sultan agreed to prescribe individuals expensive compound medications in exchange for the pharmacy agreeing to pay Sultan 35% of the reimbursements it received for the prescriptions Sultan authorized. Health care benefit programs, including TRICARE, were billed for the compounded medications. Sultan employed others who identified individuals in places like Jones County, Mississippi, who had insurance that covered the expensive compounded medications. Sultan met with the insured individuals over telemedicine video-chat sessions. However, during such meetings, he did not perform thorough examinations of the individuals and did not determine the medical necessity of the compounded medications he prescribed. Sultan knew that some of the added ingredients in the compounded medication were not effective and were added solely to increase the reimbursement value. On occasion, Sultan called in compounded medications for individuals he had not previously examined.
From May 2014 through January 2015, Sultan and his co-conspirators prescribed millions of dollars of unnecessary compounded medications to patients. In total, the Court held Sultan responsible for causing over $8 million in intended loss to health care providers. Sultan pled guilty before Judge Starrett on November 21, 2019.
Thomas Edward Sturdavant, M.D., 56, of Kingsport, Tennessee, Freda Cal Covington, R.N., 54, of Hattiesburg, Mississippi, and Fallon Deneem Page, R.N., 36, of Soso, Mississippi were all indicted along with Dr. Sultan in June 2019. Dr. Sturdavant will be sentenced next Monday, June 22, 2020. Nurse Freda Cal Covington is set for sentencing on June 24, 2020, and Nurse Fallon Page will be sentenced on July 7, 2020.
The case was investigated by the FBI and DCIS. Assistant Chief Dustin M. Davis and Trial Attorney Sara E. Porter of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Kathlyn R. Van Buskirk of the Southern District of Mississippi prosecuted the case.