Waukeshahealthinsurance.com-
The owner of a Dallas pharmacy who routinely billed insurance companies for undistributed headache sprays, pain creams and scar ointments to patients was sentenced last week to 10 years in federal prison, according to Liga Simonton, the attorney for the Northern District of Texas.
Ivor Jalah, 37, was indicted in November 2020 and pleaded guilty in June 2024 to conspiracy to commit health care fraud. U.S. District Judge Sam A. Lindsay was sentenced to 120 months in federal prison and ordered to pay $41,494,313.97 in restitution. Mr. Ivor's accomplice, Shannon Turley, 46, pleaded guilty in November 2023 to conspiracy to commit health care fraud and is due to be sentenced in November.
According to the plea papers, Mr. Jalah and Ms. Turley — who together operated at least nine Texas pharmacies including Preferred RX, EZ Pharmacy, Avenue H Pharmacy and Wallis Pharmacy — paid individuals who the insurer called “marketers” to patients with personally identifiable information. Some patients are aware of the scheme and ask marketers to pay for their information; Others were oblivious to the fraud.
Mr. Jalah and Ms. Turley have their staff enter patient information on pre-populated prescriptions. In some cases, they paid doctors by falsifying prescription forms without seeing the patients, and in other cases, they used the doctors' stamps without their knowledge.
At first, the pharmacies sent a portion of the drugs that they placed on the insurance. At some point, however, Mr. Jalah decided to stop sending any drugs he paid to the insurance company.
While the insurance companies audited the prescription claims to ensure they were legitimate, Mr. Jalah and Ms. Turley created receipts for the drug purchases to support their claims for insurance.
Mr. Jalah also instructed pharmacy staff to create a prescription log and ordered “marketers” to sign the log indicating whether patients received prescriptions. When marketers couldn't get patient signatures, Mr. Jalah instructed pharmacy staff to do so.
During the course of the scheme, Mr. Jalah and Ms. Turley submitted at least $46 million in false claims to insurers, of which $41 million were reimbursed.
Eight defendants previously pleaded guilty in connection with the pharmacy fraud and were sentenced to a total of 290 months in prison. Two other defendants await sentencing.
Source: US Attorney's Office for the Northern District of Texas
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