NC pharmacy operator pleads guilty to conspiracy to fraudulently bill Medicare, Medicaid and private insurance companies

Staff report

WILMINGTON – A Pembroke woman pleaded guilty Thursday to conspiracy to commit healthcare fraud.

According to court documents, Melisha Oxendine West pleaded guilty to conspiracy to commit healthcare fraud.

West faces a statutory maximum of 10 years in prison and a fine amounting to as much as twice the gross gain or loss from the offense. The sentencing before United States District Judge Louise W. Flanagan is to occur 90 days from the plea.

The charge to which West pled guilty alleges that from 2006 through July of 2017, West was employed at Townsend’s Pharmacy, located at 111 S. Main St. in Red Springs.

During that time, West allegedly conspired with the owner of the pharmacy and others to bill fraudulent claims to Medicare, Medicaid, and private health insurers, such as Blue Cross and Blue Shield of NC.

According to the charge, West and others are accused of fraudulently reauthorizing previously existing prescriptions from licensed medical providers and billing health care benefit programs as though those drugs had been dispensed.

Michael Easley, U.S. Attorney for the Eastern District of North Carolina made the announcement after United States Magistrate Judge Robert Jones accepted the plea. The United States Department of Health and Human Services Office of the Inspector General is investigating the case and Assistant U.S. Attorney William M. Gilmore is prosecuting the case