Insurance Fraud NEWS
9th plea handed down for Alabama pill-mill operation
June 11, 2018, Montgomery, AL
Another doctor pleaded guilty in federal court Monday, the ninth guilty plea in the ongoing investigation of an Atlanta Highway medical practice described as a pill mill by prosecutors.
Dr. Willie J. Chester, 65, of Pike Road, pleaded guilty to one count of aiding and abetting the fraudulent acquisition of controlled substances, according to a news release from the U.S. Attorney’s Office for the Middle District of Alabama. During the plea hearing, Chester admitting to writing a prescription for clonazepam, also known as Klonopin, despite knowing that the patient receiving the prescription had no legitimate medical need for the drug.
Chester faces as much as four years in prison and fines. His sentencing date hasn't been set.
Investigators have called the clinic a pill mill, alleging employees from clerical workers to physicians conspired to prescribe unnecessary controlled substances and overbill health insurance companies for services and medications.
In November, the practice’s owner Dr. Gilberto Sanchez pleaded guilty to drug distribution, health care fraud and money laundering charges. Since that time, three other physicians have pleaded guilty to drug distribution charges; two certified registered nurse practitioners have pleaded guilty to drug distribution charges; and three other employees have pleaded guilty to health care fraud and money laundering offenses.
Last week, the U.S. Attorney’s Office announced the arrest of state Rep. Ed Henry on 14 charges related to an alleged kickback scheme connected to Sanchez’s Family Practice.
The monthslong investigation snared Henry not on drug distribution charges, but for a series of agreements between Sanchez and the state legislator to funnel patients to Henry's chronic care management company while submitting false claims that overcharged Medicare for services provided.
According to federal court documents, Henry approached Sanchez around December 2015 about contracting with Family Practice.
"Among the kickbacks provided were direct payments to a member of the staff, free chronic care management services, free medical billing services, and free clinical services unrelated to the provision of chronic care management services," a DOJ release states. "Additionally, Henry assisted Dr. Sanchez in paying kickbacks to patients who enrolled in the chronic care management program. Dr. Sanchez paid these kickbacks by systematically waiving copays — copays which Medicare required Dr. Sanchez to collect."
Source: Montgomery Advertiser