HIPAA Violator Sentenced to Prison

Dom Nicastro, May 31, 2011

A federal judge has sentenced a man to six years in prison for his role in a prescription fraud scheme that included crimes of healthcare fraud, aggravated identity theft and violations of HIPAA, the U.S. Attorney's office in Alabama announced Wednesday.

U.S. District Judge C. Lynwood Smith Jr. also ordered Isaac Earl Smith, 38, who pleaded guilty to the charges in November 2009, to serve three years of supervised release after completing his prison term.

According to the release from the Alabama attorney's office, between September 2008 and April 2009, Smith:

  • Accessed the personal information of individuals who had Flexible Spending Accounts administered by United Healthcare Inc. and were also covered by a prescription drug plan sponsored by the Federal Employees Health Benefit Plan.
  • Used the information to create counterfeit prescriptions that were presented to pharmacies in order to illegally obtain controlled substances; the drugs were illegally sold to third parties.
  • Caused the federal employee's prescription drug plan to pay for the controlled substances, resulting in a loss of $72,746.

"Not only did the people involved in this scheme illegally obtain and sell prescription drugs, they used stolen identities to cause insurance plans to bear the cost of these drugs, as if they had been issued for a legitimate purpose," U.S. Attorney Joyce White Vance said in a statement.

Martin Phanco, inspector in charge of the U.S. Postal Inspection Service in Atlanta, said the healthcare industry relies on the postal service, and "when fraudsters undermine that trust, they hurt not only the healthcare industry, but also the people who really do need medical attention.

Dom Nicastro Dom Nicastro is a contributing writer. He edits the Medical Records Briefings newsletter and manages the HIPAA Update Blog.
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