Pharmacist Sentence to 10 Years for Fraud
Pharmacy Owner Sentenced to 10 Years in Prison in $41 Million Health Insurance Fraud
A Dallas pharmacy owner who routinely billed insurance companies for headache sprays, pain creams, and scar creams never dispersed to patients was sentenced Tuesday afternoon to 10 years in federal prison, announced U.S. Attorney for the Northern District of Texas Leigha Simonton.
Ivor Jallah, 37, was indicted in November 2020 and pleaded guilty in June 2024 to conspiracy to commit healthcare fraud. He was sentenced Monday by U.S. District Judge Sam A. Lindsay to 120 months in federal prison and ordered to pay $41,494,313.97 in restitution. Mr. Ivor’s coconspirator, Shannon Turley, 46, pleaded guilty in November 2023 to conspiracy to commit healthcare fraud and is set to be sentenced in November.
“By billing for prescription medication patients never needed nor received, these defendants brazenly lined their pockets at the expense of each and every client who paid into health insurance,” said U.S. Attorney Leigha Simonton. “Healthcare is already a significant expense for many Americans. We cannot and will not allow pharmacy operators to abuse the system in this way.”
“Healthcare fraud schemes are more complex, more resource-consuming, and more costly to the American taxpayer than ever. For this defendant, as one avenue to personal enrichment ran its course, he simply began operating a new pharmacy or engaging in a new method to circumvent existing system safeguards,” explained Dallas FBI Acting Special Agent in Charge P. J. O’Brien. “From fraudulent credentials to fabricated invoices, the conspiracy was designed to thwart detection. The FBI will continue to work with our partners from the Northern District of Texas, Texas Department of Insurance, and others to bring justice to criminals who attempt to undermine our healthcare system.”
According to plea papers, Mr. Jallah and Ms. Turley – who together operated at least nine Texas pharmacies, including Preferred RX, EZ Pharmacy, Avenue H Pharmacy, and Wallis Pharmacy – paid individuals they referred to as “marketers” for insured patients’ personally identifiable information. Some patients were aware of the scheme and required the marketers pay a fee for their information; others were oblivious to the fraud.
Mr. Jallah and Ms. Turley caused employees to input the patient information onto pre-populated prescription pads. In some cases, they paid physicians to fraudulently stamp prescription forms when they had not seen patients, while in other cases, they used physicians’ stamps without their knowledge.
Initially, the pharmacies shipped out a fraction of the medications they billed to insurance. At some point, however, Mr. Jallah decided to stop shipping out any medication they billed to insurance.
When insurance companies conducted audits to determine whether the prescription claims were legitimate, Mr. Jallah and Ms. Turley fabricated drug purchase invoices to support the claims they submitted to insurance.
Mr. Jallah also directed pharmacy employees to create faux prescription delivery logs and directed the so-called “marketers” to ask patients to sign the logs regardless of whether they received prescriptions. In cases where the marketers could not obtain patient signatures, Mr. Jallah directed pharmacy employees to forge them.
Over the course of the scheme, Mr. Jallah and Ms. Turley submitted at least $46 million in bogus claims to insurers, $41 million of which were reimbursed.
Eight defendants have previously pled guilty to charges associated with the pharmacy fraud and been sentenced to a combined 290 months in prison. Two other defendants await sentencing.
The Federal Bureau of Investigation’s Dallas Field Office and the Texas Department of Insurance conducted the investigation. Assistant U.S. Attorneys Marty Basu, Joshua Detzky, and Lindsey Pryor prosecuted the case with the assistance of Assistant U.S. Attorneys Katherine Miller and Lisa Dunn. Assistant U.S. Attorney Dimitri Rocha handled the forfeiture.
This has been copied from the US DOJ website at https://www.justice.gov/usao-ndtx/pr/pharmacy-owner-sentenced-10-years-prison-41-million-health-insurance-fraud
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