Tennessee physician convicted in $50M fraud scheme

A Tennessee physician and his wife were convicted in a scheme that involved billing health insurance companies for more than $50 million in fraudulent or medically unnecessary services, the Justice Department said March 2. 

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Mark Murphy, MD, and Jennifer Murphy of Lewisburg, Tenn., owned and operated North Alabama Pain Services, which closed its Alabama locations in 2017. Prosecutors allege that over a five-year period before closing the clinics, Dr. Murphy pre-signed prescriptions for thousands of patients per month, including some that didn’t have medical necessity and some written outside the usual course of professional practice.

Prosecutors also said the couple solicited and received unlawful payments for referring fraudulent or unnecessary services to patients. Ms. Murphy was also convicted of tax-related charges for underreporting the clinics’ income.

Both defendants were convicted of conspiracy to unlawfully distribute controlled substances, conspiracy to commit healthcare fraud and receiving kickbacks. The couple face up to 20 years in prison for the drug charges, 10 years for the healthcare fraud charges and five years for violations of the Anti-Kickback Statute. Ms. Murphy also faces up to three years for the tax charges. 

Sentencing is slated for June 30. 

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