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Man bilks Medicare for nearly $1M
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A government welfare recipient who racked up almost $1 million worth of medical bills in less than five years will serve three months in jail and repay less than $300 for his taxpayer-funded drug spree.
The defendant, Ivy A. Carter Jr., was doctor shopping according to the Tennessee Office of Inspector General, which leveled TennCare fraud charges against him.
The charges are a combination of state TennCare fraud and federal Medicare fraud as government agencies are scrambling to avoid accountability for the nearly $1 million oversight.
Only three of the charges against Carter are for TennCare violations, although the nearly $1 million in scammed benefits is not in question.
“He has generated more than $950,000 in filed claim benefits,” the complaint reads against Carter, noting he went on the TennCare rolls in June 2006. “This comes to more than 3,800 instances where he has gone to medical personnel to seek narcotics.”
An average taken of his doctor shopping revealed he was visiting an average of 10 different doctors and seven different pharmacies every month.
Broken down further, there are 748 days during the time period Carter is charged with abusing his benefits. His 3,800 instances of seeking narcotics translates to over five attempts every day.
The doctor-shopping spree spanned three states, investigators say.
“He not only visited 114 different physicians but also had prescriptions dispensed by 31 different pharmacies in 23 cities and three states from 2006 to 2008,” the inspector general’s office revealed, noting he had prescriptions filled in Tennessee, Georgia and Florida.
The crime is considered doctor shopping since Carter did not notify physicians he was receiving similar drugs, mostly Oxycodone and hydrocodone, from other doctors.
“He failed to notify the physicians and other health care providers when asked if he had received the same controlled substance or a prescription,” the inspector general said. “This obtaining of prescription drugs by fraud is known as the Doctor Shopping Law.”
As a result of his plea agreement, Carter will serve 90 days of a two-year sentence, pay $750 plus court costs in fines, and make $289 restitution. He will be forced to terminate his TennCare benefits but can re-apply once his probation is over.