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Jamestown Pharmacist Arrested and Charged with Health Care Fraud and Aggravated Identity Theft in a Multi-Million Dollar Health Care Fraud Scheme

Posted on December 25, 2024 by Dissent

December 23, Nashville – A federal indictment returned last week and unsealed on Friday charges Jamestown pharmacist Philip Hall, 48, with 9 counts of Health Care Fraud and 6 counts of Aggravated Identity Theft, announced Acting United States Attorney for the Middle District of Tennessee Thomas J. Jaworski.

According to the indictment, Hall was a licensed pharmacist in Tennessee and was the owner, operator, and registered agent of Hall Family Pharmacy, Inc. (“HFP”), a pharmacy with locations in Jamestown and Clarkrange, Tennessee.

Hall was the pharmacist-in-charge of HFP Jamestown and one of the pharmacists at HFP Clarkrange. From 2018 until at least May 2024, Hall submitted false claims to Medicare, Medicaid, TRICARE, and Blue Cross Blue Shield, for prescriptions for drugs that were medically unnecessary, not actually dispensed, or were not ordered by a physician or other healthcare provider. In many cases, the pharmacies lacked the inventory to even dispense these drugs. In total, Hall submitted false claims to Medicare, Medicaid, and TRICARE totaling more than $6 million. On many occasions, Hall also used the identification of other people without their authorization to obtain reimbursement for claims submitted to a health care benefit program. Hall personally profited from his participation in the scheme by receiving fraud proceeds for his personal use.

“We will always seek to protect taxpayer dollars from those who would take them fraudulently and illegally,” said Acting United States Attorney Thomas J. Jaworski. “Seniors in our community need to know that Medicare will be protected from fraud and abuse.”

If convicted, Hall faces up to ten years in federal prison for each health care fraud count, and two years consecutive in federal prison for the aggravated identity theft counts. The United States also is seeking a money judgment in the amount of $6,524,585.44, which represents the proceeds of Hall’s fraud scheme.

This case is being investigated by the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), the Tennessee Bureau of Investigation, and the Department of Defense, Office of Inspector General. Assistant U.S. Attorney Chris Suedekum is prosecuting the case.

If you believe that you or someone you know may have any information about the conduct alleged in the indictment, please contact your local HHS-OIG field office or call HHS-OIG at (888) 720-4377.

An indictment is merely an allegation. The defendant is presumed innocent until proven guilty in a court of law.

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Category: Breach IncidentsHealth DataID Theft

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