Pharmacist Arrested for Health Care Fraud and Identity Theft

A Tennessee pharmacist has been arrested and indicted on 15 charges related to a health care fraud scheme.

The Case

Philip Hall, a 48-year-old pharmacist, was the owner, operator, and registered agent of Hall Family Pharmacy, Inc., a pharmacy with 2 locations in Tennessee. Hall was the Pharmacist-in-Charge at one location and worked a pharmacist at the other. According to the indictment, from 2018 until at least May 2024, Hall submitted false claims to Medicare, Medicaid, TRICARE, and Blue Cross Blue Shield for prescriptions that were not actually dispensed, not medically necessary, or not ordered by a physician or other health care provider. The indictment further alleged that, in many cases, the pharmacies did not even have the inventory to dispense these drugs.

In total, Hall submitted more than $6 million in false claims to Medicare, Medicaid, and TRICARE. The government also accused Hall of using other individuals’ identification without permission to obtain reimbursement for claims submitted to a health care benefit program. Ultimately, Hall was charged with 9 counts of health care fraud and 6 counts of aggravated identity theft.

What is the Defendant Pharmacist Facing?

If convicted, Hall faces up to 10 years in federal prison for each health care fraud count and 2 years in federal prison, to be served consecutively, for each aggravated identity theft couns. The government is also seeking a monetary judgement of more than $6 million dollars, which it claims represents the proceeds of Hall’s fraud scheme.

The Takeaway

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

The case was investigated by the US Department of Health and Human Services Office of the Inspector General, the Tennessee Bureau of Investigation, and the Department of Defense, and is being prosecuted by Assistant US Attorney Chris Suedekum.

The government is committed to prosecuting those who take advantage of federal health programs such as Medicare, Medicaid, and TRICARE.

Reference

Jamestown pharmacist arrested and charged with health care fraud and aggravated identity theft in a multi-million dollar health care fraud scheme. Press release. US Attorney’s Office, Middle District of Tennessee. Published December 23, 2024. Accessed January 16, 2025. https://www.justice.gov/usao-mdtn/pr/jamestown-pharmacist-arrested-and-charged-health-care-fraud-and-aggravated-identity