California Pharmacist found guilty of defrauding Amtrak, Tricare health care plans
For Immediate Release
December 9, 2022
LOS ANGELES – An Orange County pharmacist was found guilty by a jury on November 22 for her role in a health care fraud scheme in which more than 1,000 bogus prescriptions for compounded medications were filled, costing various health care plans, including Amtrak’s, more than $11 million in losses, according to a press release from the US Attorney’s Office, Central District of California.
Sandy Mai Trang Nguyen, 42, of Irvine, was found guilty of 21 counts of health care fraud, and one count of obstruction of a federal audit. During the scheme, Amtrak’s health care plan was billed $32,489 of which $26,962 was paid, and Tricare, the U.S. military’s health care plan, paid $11,098,756 on the fraudulently submitted claims.
Nguyen was the pharmacist-in-charge of the now-defunct Irvine Wellness Pharmacy in Irvine. According to evidence presented during her five-day trial, Nguyen and others under her supervision filled approximately 1,150 compounded prescriptions from late 2014 to May 2015 for pain, scarring, and migraines.
As part of the scheme, beneficiaries were solicited to provide their insurance information for medications they did not seek out or need, and most were never examined by a physician. The prescriptions were electronically sent by so-called marketers or telemedicine businesses and submitted to insurers by Nguyen’s pharmacy for reimbursement. The marketers who sent the prescriptions were paid kickbacks of upwards of 50% of the Tricare reimbursements.
Nguyen faces a maximum potential sentence of 10 years in federal prison for each health care fraud count, and five years in federal prison for the audit obstruction count. Sentencing is scheduled for April 3, 2023.
In addition to the Amtrak Office of Inspector General, the case was investigated by the Department of Defense OIG; the Defense Criminal investigative Service; the FBI; IRS Criminal Investigation; the U.S. Department of Labor Employee Benefits Security Administration; the California Department of Insurance; and the Office of Personnel Management OIG.
Assistant United States Attorneys Mark R. Aveis and Ali Moghaddas of the Major Frauds Section are prosecuting this case. More information is available in the press release from the U.S. Attorney’s Office: https://direc.to/izj9.
Reports of fraud, waste, or abuse; criminal or unethical acts affecting Amtrak’s property or operations; or mismanagement in Amtrak programs or operations can be made 24 hours a day via the Amtrak OIG Hotline at 1-800-468-5469 or online at https://direc.to/hPAu. -###-