On June 10, the United States Attorney’s Office for the Northern District of Georgia announced the indictment by a federal grand jury of a former physician’s assistant, Theresa Pickering, in connection with alleged health care fraud, identity theft, and illegal distribution of controlled substances.  The government alleges that Pickering is not a licensed physician’s assistant in Georgia and has not been licensed in any state since March 2014.  Despite her lack of licensure, the government alleges that Pickering obtained a physician’s assistant position at a family medicine practice.  The government alleges that Pickering, who had previously been convicted of fraud, put patient safety at risk for her own gain by holding herself out as a licensed physician’s assistant knowing that she was not, in fact, licensed.

The government alleges that, without proper licensure and authorization, Pickering treated patients, ordered tests, and prescribed drugs, including controlled substances.  Pickering allegedly did so despite being excluded from participation in federal health care programs.  Pickering also allegedly prescribed controlled substances in the name of a physician without that physician’s permission.  This allegedly led to the submission of $147,000 in fraudulent claims for reimbursement to federal health care programs and private insurance.  Pickering has been arraigned on the charges, which are only unproven allegations at this time.

This case demonstrates the importance of having a robust internal compliance program, which includes confirming whether new hires have ever been excluded from participating in federal health care programs or faced other discipline.  

The attorneys at Chilivis Grubman represent clients of all types and sizes in connection with allegations of criminal health care fraud and other white collar criminal investigations.  If you need assistance with such a matter, please contact us today.