Amid what's being called a "record-setting" takedown, three West Tennessee residents are facing charges for their alleged roles in a $28 million health care fraud scheme. As part of a large-scale effort by the Department of Justice, these charges pinpoint an operation involving fraudulent billing practices at SarJo Pharmacy, Inc. According to the U.S. Attorney's Office for the Western District of Tennessee, the accused individuals utilized the pharmacy for fraudulent billings to the Federal Employees’ Compensation Fund (FECA).
Interim United States Attorney Joseph C. Murphy, Jr. commented on the individuals charged, including a pharmacist and two others connected with the pharmacy operation in Collierville and Memphis. Attorney General Pamela Bondi emphasized the administration's stance, "Make no mistake – this administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities." The pharmacy, not based on any valid prescription, is accused of billing FECA for medications supposedly dispensed to injured United States Postal Service claimants, as noted by the U.S. Attorney's Office.
The alleged fraudulent activities of SarJo resulted in nearly $29 million in billings, with FECA disbursing around $16 million. The charges against the defendants, who stand accused of conspiracy to commit health care fraud and wire fraud and health care fraud, reflect an extensive investigation that brought down 324 defendants nationwide. The larger effort revealed more than $14.6 billion in false billings and involved over 15 million diverted pills. In the wake of the takedown, authorities seized upwards of $245 million in cash and other assets.
In specific, local residents Kossie Lamon Simmons, Katina Marzie Simmons, and Tritia Margalizita Townsend are named in these indictments. Kossie Simmons held a beneficial ownership position and played a part in submitting false claims, Katina Simmons managed the involved entities as the majority owner, and Townsend served as a pharmacist in charge at SarJo. Collectively, their work at the pharmacy entailed fraudulent bills for prescription medications that were, in actuality, never stocked or dispensed.
Many facets of the U.S. government's law enforcement apparatus were involved in the overall operation, including regional Health Care Fraud Strike Forces and numerous U.S. Attorney's Offices. According to details available on the Department of Justice's website describing the National Health Care Fraud Takedown, these cases represent a national collaborative effort to address widespread illegal activities in the health care sector.
The prosecution of these charges is led by Trial Attorney Sara Porter of the Gulf Coast Health Care Fraud Strike Force and Assistant U.S. Attorney Raney Irwin. While an indictment itself isn't a conviction, it does suggest that authorities believe they have substantial evidence that these individuals have defrauded the health care system. Until these allegations are tested in court, the accused individuals are presumed innocent.
