Eastern District of Pennsylvania Participates in Two Nationwide Department of Justice Health Care Fraud Takedowns

PHILADELPHIA – United States Attorney William M. McSwain announced today that two individuals from the Eastern District of Pennsylvania have been charged in connection with two nationwide health care fraud takedowns.  These two cases stem from the partnership between the United States Attorney’s Office for the Eastern District of Pennsylvania and the recently formed Newark/Philadelphia Regional Medicare Fraud Strike Force, which is staffed with prosecutors from the Health Care Fraud Unit in the Fraud Section of the Justice Department’s Criminal Division. 

Federal prosecutors unsealed charges today against over 50 medical professionals in the Appalachian Regional Prescription Opioid (“ARPO”) Surge Takedown.  Those professionals were responsible for more than 30 million illegally prescribed opioids given to nearly 30,000 patients.  United States Department of Justice officials announced these charges today.  Additionally, on April 9, Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division announced a national telemedicine takedown, with 24 defendants charged in a $1.2 billion dollar fraud scheme involving international call centers, telemedicine companies, licensed medical professionals, and durable medical equipment (“DME”) companies. 

The two Eastern District of Pennsylvania cases involved in these takedowns are summarized below.

In United States v. Tayjha Brown, the defendant, 34, of Coastesville, Pennsylvania was a former licensed practical nurse who was charged by information in connection with the ARPO Surge Takedown with one count of conspiracy to distribute controlled substances.  The charges stem from Brown’s role in filling fraudulent prescriptions in her name and in the names of others at a local pharmacy in order to obtain oxycodone for herself and to distribute.  Brown forged the prescriptions primarily from prescription pads and paper she stole from her employers.  The defendant provided approximately 30 oxycodone pills from each fraudulent prescription not written in her name to her co-conspirators. 

In United States v. Randy Lee Swackhammer, the defendant, 60, of Goldsboro, North Carolina was a medical doctor licensed in four states who was charged by information with one count of conspiracy to commit health care fraud.  The charges stem from Swackhammer’s role in the telemedicine fraud scheme in which he conspired with telemedicine companies to prescribe medically unnecessary orthotic braces to unsuspecting Medicare beneficiaries following brief phone calls.  The referrals caused the submission of approximately $5 million in false and fraudulent claims to the Medicare program.  Swackhammer neither conducted in-person examinations nor meaningful telephonic evaluations prior to prescribing at least one, and often multiple, orthotic braces. 

“The Newark/Philadelphia Regional Medicare Fraud Strike Force is producing results for the people and businesses who are hurt by this type of crime and for all taxpayers who support government programs like Medicare,” said U.S. Attorney McSwain.  “These two cases exemplify the great work being done to root out fraud, waste and corruption.”

“Whether it’s the unlawful diversion of Medicare funds or prescription drugs, the FBI will continue to crack down on all manner of health care fraud,” said Michael T. Harpster, Special Agent in Charge of the FBI’s Philadelphia Division. “Medical professionals who choose to engage in these crimes should know that the next knock at your door could very well be Special Agents with a search warrant.”

The Brown case was investigated by the Office of Personnel Management-Office of Inspector General, Federal Bureau of Investigation, Department of Health and Human Services-Office of Inspector General, Drug Enforcement Administration and United States Marshals Service.  The case is being handled by Assistant United States Attorney Paul J. Koob and DOJ Trial Attorney Adam G. Yoffie, who is one of two prosecutors assigned to the Eastern District of Pennsylvania from the Health Care Fraud Unit in the U.S. Justice Department’s Criminal Division’s Fraud Section.

The Swackhammer case was investigated by the Federal Bureau of Investigation, Department of Health and Human Services-Office of Inspector General, Internal Revenue Service, United States Postal Inspection Service, and auditor Dawn Wiggins.  The case is being handled by DOJ Trial Attorney Adam G. Yoffie.