Kentuckiana Physician and Nurse Practitioner Sentenced for Conspiracy to Distribute Controlled Substances, Conspiracy to Commit Health Care Fraud, Health Care Fraud, and Conspiracy to Commit Money Laundering
A local physician and an advanced practice registered nurse were sentenced yesterday on conspiracy to unlawfully distribute and dispense controlled substances, conspiracy to commit health care fraud, health care fraud, and conspiracy to commit money laundering charges. The physician’s medical practice was also sentenced for conspiracy to unlawfully distribute and dispense controlled substances and conspiracy to commit health care fraud.
On March 29, 2023, physician Jeffrey Campbell, age 64, was sentenced in the U.S. District Court for the Western District of Kentucky to 105 months in prison, followed by a 3-year term of supervised release, for conspiracy to unlawfully distribute and dispense controlled substances, conspiracy to commit health care fraud, health care fraud, and conspiracy to commit money laundering. Advanced practice registered nurse Mark Dyer, age 54, was sentenced to 60 months in prison, followed by a 3-year term of supervised release, for conspiracy to unlawfully distribute and dispense controlled substances, conspiracy to commit health care fraud, health care fraud, and conspiracy to commit money laundering. There is no parole in the federal system.
Additionally, Campbell’s medical practice, Physicians Primary Care, PLLC (PPC) was ordered to pay a fine of $1,000,000 for conspiracy to unlawfully distribute and dispense controlled substances and conspiracy to commit health care fraud.
According to court documents and evidence presented during the jury trial in May and June of 2021, Campbell, Dyer, and PPC conspired to unlawfully distribute and dispense controlled substances between January 1, 2009, and December 1, 2016. Campbell, Dyer, and PPC also conspired to commit health care fraud for falsely and fraudulently billing Kentucky Medicaid (Passport), Indiana Medicaid, Tricare, Medicare, and other health care benefit programs by submitting claims for physical therapy, counseling and exercise services using evaluation and management codes to obtain higher reimbursement. Campbell and Dyer also conspired to commit money laundering for paying and/or receiving bonuses to incentivize the ordering of physical therapy, counseling, and exercise. Finally, Campbell and Dyer fraudulently billed for physical therapy services using evaluation and management codes as if a physician performed a service on the patients, but, a non-physician and non-physical therapist performed the service on the patients.
U.S. Attorney Michael A. Bennett of the Western District of Kentucky; Kentucky Attorney General Daniel Cameron; Indiana Attorney General Todd Rokita; Special Agent in Charge Mario Pinto of the United States Department for Health and Human Services (HHS), Office of Inspector General, Office of Investigations, Chicago Regional Office; Special Agent in Charge Darrin K. Jones of the Defense Criminal Investigative Services (DCIS) Southeast Field Office; Special Agent in Charge Jodi Cohen of the FBI Louisville Field Office; Special Agent in Charge J. Todd Scott of the DEA Louisville Field Division; and Special Agent in Charge Bryant Jackson of the Internal Revenue Service, Criminal Investigation (IRS-CI), Cincinnati Field Office made the announcement.
The case was investigated by the HHS, DCIS, IRS-CI, FBI, DEA, the Kentucky Attorney General Office’s Medicaid Fraud Control Unit, and the Indiana Attorney General’s Office.
Assistant United States Attorneys Joseph Ansari and Christopher Tieke prosecuted the case with assistance from health care fraud investigator Bob Masterson of the U.S. Attorney’s Office.
This effort is part of an Organized Crime Drug Enforcement Task Forces (OCDETF) operation. OCDETF identifies, disrupts, and dismantles the highest-level criminal organizations that threaten the United States using a prosecutor-led, intelligence-driven, multi-agency approach. Additional information about the OCDETF Program can be found at www.justice.gov/OCDETF.
Tags: Arrests Healthcare Fraud Medically Unnecessary Money Laundering Nurse Provider Arrest Rx Fraud