A Red Bud, IL pharmacist has pleaded guilty to health care fraud charges, admitting that he defrauded Medicare, Medicaid, and private insurers out of more than $630,000. Steven P. Gibson, owner of Gibson’s Discount Drugs at 1506 S. Main Street, will spend up to 10 years in prison for the crime.
Gibson’s scam was simple: he wrote false prescriptions for expensive drugs and submitted them to public and private insurers for reimbursement. The prescriptions were submitted under the names of his friends, family, and customers without their knowledge or consent. There were no authorizations from doctors or any other medical professionals, and the prescriptions were never filled or given to the people whose names were on them—because the scripts were entirely fraudulent.
Gibson was blatant in his quest for money. He specifically wrote false prescriptions for expensive medications he knew would fetch high Medicare and Medicaid reimbursement rates, like ulcerative colitis medicine Pentasa and Creon, a treatment for chronic pancreatitis. He also submitted claims for Hydroxychloroquine, a malaria treatment.
Perhaps that was the prescription that tipped the feds off. Gibson’s Discount Drugs is in a small town in southwest Illinois, about 30 miles south of St. Louis. How many people could possibly have malaria in an American city with fewer than 4,000 people?
Health care fraud happens in pharmacies all the time, but what makes this case different is the brazen way Gibson implemented his scheme. To put it bluntly, he did the most obvious thing a pharmacist could do to make a quick buck, and it seems like he didn’t attempt to hide his crimes. It’s amazing that Gibson thought he could get away with this long-term.
And get away with it he certainly didn’t. Gibson’s plan only held up for a little more than a year. He purchased the pharmacy with his wife, Rachel Gibson, in Oct. 2016, less than two years ago. Federal investigators knew about the fraud by early 2018, if not sooner. Illinois State Police served a warrant on the pharmacy in Feb. 2018 and conducted an extensive search, eventually leading to Gibson’s indictment and guilty plea.
That investigation made headlines, but Gibson brushed any rumors of wrongdoing off. At the time, he told reporters that the search was related to Medicare Part D and was similar to an insurance audit. In fact, he even bragged to the Belleville News-Democrat that he had “increased the prescription part of the business by about 150 percent in 20 months through careful buying and ‘being real aggressive with new customers.’” He neglected to mention that those “new” customers didn’t know fraudulent prescriptions were being written under their names.
Gibson was charged in U.S. District Court in East St. Louis and pleaded guilty. In addition to a potentially decade-long prison sentence, he could be given up to three years’ probation and be fined up to $250,000. His sentencing is scheduled for Nov. 27, 2018.
Although investigators picked up on Gibson’s crimes relatively quickly, other Medicare and Medicaid fraudsters aren’t so easy to pin down. If you know of any criminal pharmacists, you can help put an end to the fraud by reporting what you know. Under the False Claims Act, whistleblowers are entitled to a percentage of verdicts and settlements, which are often millions of dollars.
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