United States of America v. Barbara A. Smith

Knoxville, Tennessee, criminal defense lawyer represented the Defendant charged with conspiracy to commit health care fraud.

Reported by Kent Morlan

Barbara A Smith 75, of Powell, Tennessee, was paid for formularies signed by the clinic’s providers. Woods and Smith then began to alter signed formularies, adding check boxes next to unprescribed medications and increasing the number of refills written on the formularies. The clinic’s patients began to complain about receiving medications in the mail that their provider had not prescribed and that they did not want, which led the clinic’s providers to suspect Smith of altering their formularies. As a result, the providers completed formularies to prevent alterations, including crossing out medications by drawing an “X” on them.

Woods and Smith then used blank formularies to create wholly forged formularies: they handwrote patient names on the formularies, marked boxes next to various medications, wrote in refills, and forged providers’ signatures—either by hand or by using a photocopy of the provider’s signature without the provider’s knowledge. Woods paid Smith in cash for Smith’s role in altering and forging the formularies.

Grant Riddle submitted, or caused United Apothecary to submit, the altered and forged formularies to drug plans and pharmacy benefits managers for reimbursement. As a result of those fraudulent claims, the drug plans and pharmacy benefits managers paid to United Apothecary approximately $7,365,897.89, including approximately $4.8 million paid by Medicare Part D. During portions of the scheme, Riddle Drugs’ Oliver Springs, Tennessee, pharmacy was the top pharmacy in the country for distribution of chlorzoxazone 250 mg.

Riddle Health Care Kickbacks Case: Ernest Riddle and Grant Riddle

In a separate case also involving Riddle Drugs, George Ernest Riddle (“Ernest Riddle”), 78, of Clinton, Tennessee, was sentenced by Judge Crytzer to 15 months’ imprisonment, two years of supervised release, and was ordered to pay restitution in the amount of $1,321,634.00.

The Defendant elected to plead guilty and was sentenced to 37 months’ imprisonment and one year of supervised release. Smith was also ordered to pay restitution in the amount of $4,810,878.