Tennessee Nurse Practitioner Pleads Guilty to $65 Million TRICARE Fraud
Candace Michelle Craven, a 52-year-old nurse practitioner from Tennessee, pleaded guilty in federal court to participating in a health care fraud scheme that bilked TRICARE, the health care program for United States service members, out of more than $65 million.
According to the guilty plea, Craven conducted sham ‘telemedicine’ evaluations that resulted in the prescription of exorbitantly expensive compounded medications to patients she never saw or examined in person. The prescriptions were then signed by doctors employed by Choice MD, a Tennessee medical clinic that employed Craven, and were sent directly to particular pharmacies controlled by co-conspirators, which filled the prescriptions and billed TRICARE at exorbitant prices.
The scheme involved a team of individuals who worked to recruit and pay Marines, primarily from the San Diego area, and their dependents – all TRICARE beneficiaries – to obtain compounded medications that would be paid for by TRICARE.
Between December 2014 and May 9, 2015, doctors working at Choice MD signed 4,442 total prescriptions, resulting in a loss of $65,679,512 for TRICARE.
Craven’s guilty plea marks the seventh defendant charged in relation to this fraud scheme. Josh Morgan, a former Marine from San Diego, pleaded guilty in April to Conspiracy to Commit Health Care Fraud for his role in recruiting TRICARE beneficiaries to fraudulently receive these prescriptions. The doctors who signed the prescriptions, Carl Lindblad and Suzy Vergot, pleaded guilty to the same charges in September.
According to the U.S. Attorney’s Office, the case is being prosecuted by Assistant United States Attorneys Benjamin J. Katz and Mark W. Pletcher.
Craven is scheduled to be sentenced on February 8, 2019, and faces a maximum penalty of 10 years’ imprisonment and a fine of the higher of $250,000 or double the loss amount.
Key Facts
- State: California
- Category: Health Care Fraud
- Source: DOJ Press Release â†â€â€
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