Paul Roberts, MD, 48, of Fultondale, Ala, a physician and former co-owner of Southeast Urgent Care in Fultondale, pleaded guilty to prescribing controlled substances without a legitimate medical purpose and engaging in healthcare fraud. According to the plea agreement, Roberts stipulated to a 72-month sentence and agreed to surrender his Alabama and other State medical licenses. He also agreed to pay a fine of $100,000 and restitution of $2.2 million. Roberts pleaded guilty to 12 counts of prescribing controlled substances without a legitimate medical purpose. According to the plea agreement, on days Roberts was out of the office, he allowed unqualified staff, including an x-ray technician, to prescribe controlled substances to patients using prescriptions that Roberts pre-signed. Roberts also pleaded guilty to two healthcare fraud conspiracies and two counts of participating in a healthcare fraud scheme. The first focused on fraudulently billing for office visits. According to the plea agreement, on dates he was absent from the office, Roberts caused unqualified staff to see patients, and then caused SEUC to bill Blue Cross Blue Shield of Alabama as though Roberts had provided those services.
The second conspiracy and scheme focused on fraudulently billing health insurance plans through their third-party administrators for compounded drugs. According to the plea agreement, beginning in 2012, Roberts entered into an unlawful agreement with his co-defendants, Stanley Reeves, 62, a pharmacist and owner of F&F Drugs, a Demopolis-based pharmacy, and Brett Taft, a Tuscaloosa-based sales representative, to fraudulently bill these health insurance plans for medically unnecessary compounded drugs. To induce Roberts to issue these medically unnecessary drugs, Taft paid Roberts kickbacks. Roberts then issued the prescriptions, sometimes without patients’ knowledge, and sent them to F&F Drugs, which then filled and billed the prescriptions to insurance plans. Reeves would then pay Taft a portion of the billing proceeds, with Taft using some of those proceeds to pay Roberts kickbacks. In addition, to induce patients to accept these medically unnecessary drugs, Roberts and his co-defendants agreed that F&F Drugs would waive patient co-pays, and did so in violation of the health insurance plan rules. And, to maximize profit from each prescription, Roberts and his co-defendants also agreed that F&F Drugs would automatically refill the compounded drugs that Roberts referred regardless of whether patients needed those drugs. Between April 2012 and February 2014, F&F Drugs billed health insurance plans approximately $2.2 million for medically unnecessary compounded drugs issued by Roberts. Under the terms of the plea agreement, Reeves stipulated to a 38-month sentence and agreed to surrender his pharmacist license to the Alabama Board of Pharmacy. He also agreed to pay a fine of $100,000, restitution of $10.5 million, and forfeiture of $900,000 with $300,000 due on the date he is sentenced.
