Owner of Crume Drug Store faces fraud charges

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Sizemore accused of billing insurance companies, Medicare Part D for fraudulent prescriptions

By Forrest Berkshire, Editor

One year after the FBI raided his shop, the owner of Crume Drug Store in Bardstown is facing charges of health care fraud and wire fraud.

Timothy Sizemore, 36, is accused of billing private insurance companies and Medicare Part D for fraudulent prescriptions, David J. Hale, the U.S. Attorney for the Western District of Kentucky, announced in a press release Friday.

A federal information was filed Wednesday.

Friday's press release states Sizemore "knowingly devised and executed a scheme, between April 2010 and February 2012, whereby he used patients' and doctors' names to create fraudulent prescriptions, and billed Anthem and other private insurance companies for those fraudulent prescriptions, even though, those prescriptions were never filled."

He is also accused of operating the same scheme against Medicare Part D.

Sizemore could face up to 30 years in prison and a fine of $500,000 if convicted at trial, according to the statement.

However, that is unlikely, given that the charge came through an information, as opposed to a grand jury indictment. With a grand jury indictment, evidence is presented to a 23-person jury. Under an information, the prosecutor files the charges directly.

Most often, when a federal information is filed, the accused has cooperated and has worked out a plea agreement. Should negotiations between the defendant and prosecutors break down, a grand jury indictment can still be sought.

An initial appearance has been scheduled for 1:30 on March 19 before Federal Magistrate Judge James Moyer, according to Sizemore's attorney, Scott C. Cox, of Louisville.

Sizemore could not be reached for comment.

Employees at the store Friday declined to comment, referring all inquiries to Cox.

Reached by phone late Friday, Cox declined to comment about specifics of the charge filed against his client.

Stephanie Collins, a spokeswoman for the U.S. Attorney's Office, also declined to comment on any specifics of the case.

The FBI and the U.S. Department of Health and Human Services Office of the Inspector General are investigating the alleged crime.

The drug store, located at 111 W. Flaget Ave., was searched Feb. 28, 2012, by the FBI. At that time, agents were seen removing boxes from a second floor storage room and interviewing employees.

The filing of an information of a person by a federal prosecutor is an accusation only.