PA. A.G. HENRY: BRADFORD COUNTY NURSE PRACTITIONER SENTENCED TO 10 YEARS OF PROBATION FOR $450K IN PRESCRIPTION FRAUD - Insurance News | InsuranceNewsNet

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April 28, 2023 Newswires
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PA. A.G. HENRY: BRADFORD COUNTY NURSE PRACTITIONER SENTENCED TO 10 YEARS OF PROBATION FOR $450K IN PRESCRIPTION FRAUD

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HARRISBURG, Pennsylvania, April 28 -- Pennsylvania Attorney General Michelle Henry issued the following news release:

Attorney General Michelle Henry announced today that a Bradford County nurse practitioner was sentenced to ten years of restrictive probation after pleading guilty last month to prescribing medications without a collaborating doctor and false billing.

Stefanie King, 46, of Ulster, Pa., will serve ten years of probation, with the first six months on home confinement with an electronic monitor, and pay nearly $450,000 restitution.

King was sentenced Monday in Bradford County Court after pleading guilty last month to several felonies. Some of the criminal conduct happened while she was engaged in an inappropriate relationship with a patient.

King previously surrendered her Certified Registered Nurse Practitioner's license.

"The defendant abused her position of trust by engaging in conduct that served herself and violated a system meant to assist our most vulnerable residents," said AG Henry. "My office is committed to holding accountable those who put patients at risk and compromise our health care programs."

The investigation found that King falsely billed in excess of $300,000 to private insurers, as well as $100,000 to the Commonwealth, for services below acceptable medical treatment standards. Additionally, she wrote over 3,750 prescriptions to patients while not meeting the requirements to prescribe under Pennsylvania law.

King entered into a sexual relationship with a patient beginning in November 2016 at her Athens practice and billed a private insurer for time they spent together not related to medical care. King later entered into a second relationship with a different patient and continued to prescribe controlled substances to him, despite discontinuing medical care after the relationship began.

Under Pennsylvania law, nurse practitioners are required to enter into collaborative agreements with Pennsylvania licensed physicians in order to perform medical diagnoses and to prescribe controlled substances. Investigators also found that King misled past physician collaborators and renewed previous agreements without their knowledge.

In all, King pleaded guilty to one felony count of violating the Controlled Substance Act- Obtained by Subterfuge; one felony count of Medicaid Fraud; one felony count of Insurance Fraud; and one felony count of violating the Controlled Substance Act- Delivery by Practitioner. She has agreed not to practice as a nurse for the duration of her sentence and voluntarily surrendered her license to practice as a Certified Registered Nurse Practitioner. She will pay restitution of $348,760 to Highmark and $100,425 to Community Care Behavioral Health Organization.

This case was prosecuted by Senior Deputy Attorney General Mark Bellavia and Senior Deputy Attorney General Christopher R. Sherwood.

The Pennsylvania Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $9,781,180 for Federal fiscal year (FY) 2023. The remaining 25 percent, totaling $3,260,392 for FY 2023, is funded by Pennsylvania.

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Original text here: https://www.attorneygeneral.gov/taking-action/case-update-bradford-county-nurse-practitioner-sentenced-to-10-years-of-probation-for-450k-in-prescription-fraud/

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