Monday, July 23, 2018
Federal grand jury indicts Carl Junction pharmacy owner on Medicare, Medicaid fraud; Botts pleads guilty
Jerry Eugene Botts, 62, who was the co-owner of Bruner Pharmacy in Carl Junction pleaded guilty this morning in U. S. District Court in Springfield to a charge of health care fraud.
The guilty plea came at the same time as the federal grand jury indictment for the crime was unsealed.
Botts will also be required to surrender his pharmacist's license.
The details of Botts' crimes were spelled out in the plea agreement document:
On or about March 5, 2015, special agents with the Department of Health and Human Services received information from former employees of Bruner Pharmacy, located in the city of Carl Junction, Jasper County, Missouri, within the Western District of Missouri.
The former employees advised agents that JERRY EUGENE BOTTS (BOTTS), the defendant, who was the licensed pharmacist and 50% owner of Bruner Pharmacy, was defrauding federal health care benefit programs.
The former employees informed agents that BOTTS would set some of his current patients to receive automatic prescription refills. The former employees advised that BOTTS would place the filled prescriptions in the “pick-up drawer,” and process claims for payment with each patient’s corresponding health care benefit program.
The health care benefit programs included Medicare, Medicaid, and TRICARE. All of the health care programs involved were health care programs as defined by Title 18, United States Code, Section 24(b).
Agents were then told that in many cases, the patients for whom BOTTS scheduled automatic refills, were either unaware of his actions or did not pick up their prescriptions.
The former employees, who included pharmacy technicians, noted that the prescriptions that were not picked up, were removed from the “pick-up drawer” by BOTTS but the claims against each patient’s health care benefit program were not rescinded, recalled or reversed.
As a result, BOTTS and his pharmacy would receive full payment for medical prescriptions that were not picked up or claimed by the individual patient. Agents then conducted an analysis of the Computer Rx program that was utilized by BOTTS and his pharmacy.
Upon reviewing records between January 1, 2013, through July 1, 2016, agents observed that there were significant irregularities with records associated with the Computer Rx program.
Agents noted that in many instances, a customer’s signature would not appear in the signature field indicating that they had received the corresponding prescription. Agents noted that instead of a signature, a “wavy line” would appear in lieu of a patient’s signature. Agents observed that the “wavy line” appeared in place of the signature of several patients who were customers of BOTTS and his pharmacy, while at other times, the customers signed their own names.
When contacted, each customer told agents that when they received their prescriptions from BOTTS, they would sign their names and not use a “wavy line.”
Agents noted that the same “wavy line” was used sporadically for multiple customers, indicating that the same person was leaving the mark in the signature field for different customers. Agents were told by BOTTS’ former employees that after the pharmacy closed each night, the prescriptions were still in the “pick-up drawer,” but the next morning they observed that some prescriptions were gone, the records would show the “wavy line” indicating that the medications had been picked up, and the co-pay would be “zeroed out” on the register.
The former employees told agents that BOTTS was the only person with access to the prescriptions and the computer system. The former employees noted that because the pharmacy was closed, the customers could not have picked up their prescriptions. The former employees advised that BOTTS “zeroed out” the co-pay for each prescription because it was necessary to ensure that the cash drawer for each night would balance out. The former employees advised that BOTTS had access to these records and the register, and would have to “zero out” the co-pay or he would have to take the money out of his own pocket to ensure that the register balanced each night.
The agents noted that by writing the “wavy line” and “zeroing out” the co-pay, BOTTS was able to avoid reversing the health care program payments. Agents then contacted Osborn Drugs, a pharmaceutical company in Oklahoma, who was also a 50% owner of Bruner Drugs. Osborn Drugs conducted its own internal investigation.
Osborn Drugs determined that between January 1, 2012 through August 3, 2017, there were numerous clerical irregularities committed by BOTTS as the licensed pharmacist for Bruner Drugs.
With federal agents, Osborn Drugs determined that BOTTS failed to reverse and refund claims he made or caused to be made to various health care benefit programs for prescriptions that were ordered but never delivered or picked up by the rightful patient.
Federal agents as well as investigators for Osborn Drugs determined that BOTTS’ actions and willful failure to reverse these claims caused approximately $115,246.00 in claims to be paid that ultimately resulted in $59,246.00 in losses to various health care benefit programs, like Medicare, Medicaid, and TRICARE.
Based on the statements from former employees of BOTTS and Bruner Drugs, as well as records from the Computer Rx program, and the investigation by federal agents and Osborn Drugs, it was determined that BOTTS, between January 1, 2012, through August 3, 2017, knowingly and willfully executed and attempted to execute a scheme to defraud health care benefit programs as defined in Title 18, United States Code, Section 24(b), in that BOTTS made claims for payments for prescriptions that he knew were not delivered or picked up by his patients, yet BOTTS retained control over the prescriptions without reversing the transactions and returning the monies to the appropriate health care benefit programs.
Specifically, on or about April 30, 2014, in Jasper County, Missouri, within the Western District of Missouri, JERRY EUGENE BOTTS, the defendant, for the purpose of executing the aforementioned scheme, fraudulently signed patient signatures with a “wavy line,” “zeroed out,” patient co-pays, and intentionally and willfully failed to reverse or refund payments made to him and his pharmacy by health care benefit programs for 29 prescriptions that were fraudulently reported as being issued and received by the rightful patients associated with either Medicare, Medicaid, or TRICARE. These actions, BOTTS admit constitute the offense of health care fraud pursuant to Title 18, United States Code, Section 1347