Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 1 of 11 PageID# 2

Transcription

1 . Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 1 of 11 PageID# 2 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF VIRGINIA JUL Alexandria Division UNITED STATES OF AMERICA v. Case No. I:12mj396 PETER PRESSMAN, Defendant. AFFIDAVIT IN SUPPORT OF CRIMINAL COMPLAINT I, Edward J. Martin, after being duly sworn, depose and state as follows: A. INTRODUCTION 1. I am a Special Agent with the Naval Criminal Investigative Service (NCIS), Washington, DC Field Office. I am assigned to the General Crimes Squad which investigates criminal activity violating federal laws involving U.S. Navy and Marine Corps personnel, civilian U.S. Government employees working for the U.S. Navy and Marine Corps, and employees contracted by the U.S. Navy and Marine Corps. I have been an NCIS Special Agent since February 2009, and have received training at the Federal Law Enforcement Training Center in criminal investigations. In addition, during my tenure as an NCIS Special Agent, I have received training pertaining to criminal investigations that involve the abuse, possession, and distribution of"prescription narcotics. 2. This affidavit is submitted in support of a criminal complaint charging PETER PRESSMAN (hereafter "PRESSMAN") with knowingly transferring, possessing, or using,

2 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 2 of 11 PageID# 3 without lawful authority, a means of identification of another person in violation of Title 18, United States Code, Section 1028A. This affidavit is also submitted in support ofthe issuance of an arrest warrant. 3. In preparing this affidavit, I have been assisted by other federal law enforcement agents including members ofthe Office ofpersonnel Management: Office ofthe Inspector General, and the Federal Bureau ofinvestigation. This affidavit is based upon information and evidence provided by witness statements and reports submitted by other agents, as well as physical evidence and my own personal knowledge, training, and experience. This affidavit contains information necessary to support probable cause, and is not intended to include each and every fact and matter known to me or to the government. B. STATUTORY OFFENSES 4. Section 1028A oftitle 18, United States Code, provides, in part: Whoever, during and in relation to any felony violation enumerated in subsection (c), knowingly transfers, possesses, or uses, without lawful authority, a means of identification ofanother person shall, in addition to the punishment provided by such felony, be sentenced to a term ofimprisonment of2 years. [...] For purposes ofthis section, the term "felony violation enumerated in subsection (c)" means any offense that is a felony violation of [...] any provision contained in this chapter. 5. Section 1035 oftitle 18, United States Code, provides, in part: Whoever, in any matter involving a health care benefit program, knowingly and willfully [...] makes any materially false, fictitious, or fraudulent statements or representations, or makes or uses any materially false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or entry, in connection with the delivery ofor payment for health care benefits, items, or services, shall be fined under this title or imprisoned not more than 5 years, or both.

3 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 3 of 11 PageID# 4 C. SUMMARY OF INVESTIGATION 6. In November 2011, NCIS, the Office ofpersonnel Management: Office ofthe Inspector General, and the Federal Bureau of Investigation began investigating allegations that PRESSMAN, an active duty U.S. Navy medical doctor, was submitting false billings to health care benefit programs. An individual reported to his/her health insurance carrier that he/she discovered discrepancies while reviewing his/her prescription history. The prescription history reflected that the individual supposedly received prescriptions prescribed by PRESSMAN for which his/her insurance company was billed. However, he/she did not receive those medications nor did he/she use the pharmacy where the prescriptions were filled. The ensuing investigation revealed that PRESSMAN was calling in or falsifying the prescriptions using members' identities to obtain controlled substances for his own use. The fraudulent prescriptions led to the submission ofmaterially false claims to BlueCross BlueShield via their pharmacy benefit manager, CVS/Caremark,1 in order to receive medications which PRESSMAN never provided to various beneficiaries ofthe Federal Employees Health Benefits Program (FEHBP) and other health care benefit programs. 7. Beginning in November 2011, employees ofthe Department ofdefense (hereafter "DoD") Task Force for Business and Stability Operations (hereafter "TFBSO") located in Arlington, Virginia, within the Eastern District of Virginia, were contacted by NCIS regarding irregular prescriptions written in their names by PRESSMAN originating from CVS Pharmacy #2712, which filled the prescriptions under the FEHBP. This CVS is located within the 1The Federal Employees Health Benefits Program (FEHBP) is a federally funded healthcare benefits program funded by the Federal government forthe benefit of government employees, retirees, and their dependents. The FEHBP is administered by the Office of Personnel Management. With regards to this investigation, the program representingthe FEHBP's retail pharmacy program is BlueCross BlueShield's pharmacy benefit manager, CVS/Caremark.

4 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 4 of 11 PageID# 5 Pentagon Reservation, which is within the Special Maritime and Territorial Jurisdiction of the United States and is located within Arlington, Virginia, in the Eastern District ofvirginia. 8. On November 28, 2011, G. H., a federal government employee oftfbso, provided a sworn statement to an NCIS Special Agent. G.H. stated that on November 10,2011, he/she retrieved his/her prescription history from the Pentagon CVS. According to G.H.'s prescription history the following prescriptions were written by PRESSMAN and filled in G.H.'s name: On September 7, 2011, one prescription for 200 tablets of hydrocodone/ibu, a August 11,2011, one prescription for 300 tablets ofhydrocodone/ibu, a Schedule III narcotic; and one prescription for 100 tablets of hydrocodone/acetaminophen, a G.H. stated he/she had no knowledge ofthese prescriptions and did not receive the tablets. 9. On November 30,2011, J. D., a federal government employee oftfbso and a beneficiary of the FEHBP, provided a sworn statement to an NCIS Special Agent. J.D. stated that on November 9, 2011, he/she retrieved his/her prescription history from the Pentagon CVS. J.D. found 17 prescriptions in his/her name written by PRESSMAN which he/she did not recognize. According to J.D.'s prescription history, the following prescriptions were written by PRESSMAN and filled in J.D.'s name: On January 4,2011, one prescription for 30 tablets of propranolol; one prescription for 30 tablets of clonazepam, a Schedule IV tranquilizer; and one prescription for 100 tablets ofhydrocodone/ibu, a Schedule III narcotic. On January 19, 2011, one prescription for hydrocodone-homatropine syrup, a On January 25, 2011, one prescription for 100 tablets of hydrocodone/ibu, a

5 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 5 of 11 PageID# 6 On January 31,2011, one prescription for 100 tablets of hydrocodone/ibu, a On February 2,2011, one prescription for 100 tablets of hydrocodone/ibu, a On March 1,2011, one prescription for 90 tablets of hydrocodone/acetaminophen; and one prescription for 10 tablets of hydrocodone/acetaminophen, both Schedule III narcotics. On March 24, 2011, one prescription for 100 tablets of hydrocodone/acetaminophen, a Schedule III narcotic; one prescription for 100 tablets ofhydrocodone/ibu, a Schedule III narcotic; and one prescription for 30 tablets ofcephalexin. On April 14, 2011, one prescription for 100 tablets ofhydrocodone/ibu, a On May 2,2011, one prescription for 200 tablets ofhydrocodone/ibu, a On June 17, 2011, one prescription for 200 tablets ofhydrocodone/ibu, a On July 8,2011, one prescription for hydrocodone-homatropine syrup, a On September 6,2011, one prescription for 200 tablets of hydrocodone/ibu, a J.D. stated he/she had no knowledge ofthese prescriptions and did not receive the tablets. 10. On January 9, 2012, H.B., a federal government employee oftfbso and a beneficiary of the FEHBP, provided an NCIS Special Agent with copies of his/her prescription history from the Pentagon CVS. According to the prescription history, the following prescriptions were written by PRESSMAN and filled in H.B's name: On April 22, 2011, one prescription for 100 tablets of hydrocodoneacetaminophen, a Schedule III narcotic; and one prescription for 10 tablets of Ievaquin. On May 23, 2011, one prescription for 100 tablets ofhydrocodoneacetaminophen, a Schedule III narcotic; and one prescription for 200 tablets ofhydrocodone, a

6 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 6 of 11 PageID# 7 On July 22,2011, one prescription for 200 tablets of hydrocodone, a Schedule III narcotic; and one prescription for 100 tablets hydrocodoneacetaminophen, a Schedule HI narcotic. On September 22,2011, one prescription for 100 tablets of hydrocodoneacetaminophen, a Schedule III narcotic; one prescription for 300 tablets of hydrocodone, a Schedule III narcotic; and one prescription for 28 tablets ofcephalexin. H.B. stated that he/she had no knowledge ofthese prescriptions and did not receive the above medications. In addition, H.B. stated that he/she had never personally filled a prescription at the Pentagon CVS. 11. On January 11, 2012, E. C, a federal government employee oftfbso, provided a sworn statement and his Pentagon CVS prescription history to an NCIS Special Agent. In addition, E.C. is insured through TRICARE, a U.S. Government health benefit plan for Uniformed Service members, retirees, and their families. The following prescriptions were written by PRESSMAN and filled in E.C.'s name: On April 18,2011, one prescription for 200 tablets ofhydrocodone/ibu, a Schedule III narcotic; and one prescription for 100 tablets of hydrocodone/acetaminophen, a On May 4, 2011, one prescription for 200 tablets ofhydrocodone/ibu, a On June 15, 2011, one prescription for 200 tablets ofhydrocodone/ibu, a Schedule III narcotic; and one prescription for 100 tablets of hydrocodone/acetaminophen, a On July 1, 2011, one prescription for 200 tablets ofhydrocodone/ibu, a On August 31,2011, one prescription for 300 tablets ofhydrocodone/ibu, a One September 14,2011, one prescription for 100 tablets of hydrocodone/acetaminophen, a Schedule III narcotic; and 4 tablets of Cialis. E.C. stated he/she had no knowledge ofthe above prescriptions and did not have a need for them.

7 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 7 of 11 PageID# On February 10, 2012, P. B., a federal government employee oftfbso and a beneficiary ofthe FEHBP, provided a sworn statement and his/her Pentagon CVS prescription history to an NCIS Special Agent. The following prescriptions were written by PRESSMAN and filled in P.B's name: On February 22,2011, one prescription for 100 tablets of hydrocodone/ibu, a Schedule III narcotic; and one prescription for 12 tablets ofcialis. On March 10,2011, one prescription for 100 tablets of hydrocodone/acetaminophen, a On March 28, 2011, one prescription for 100 tablets ofhydrocodone/ibu, a Schedule III narcotic; and one prescription for 12 tablets ofcialis. On May 18,2011, one prescription for 200 tablets ofhydrocodone/ibu, a On June 7,2011, one prescription for 200 tablets ofhydrocodone/ibu, a On July 8,2011, one prescription for 200 tablets ofhydrocodone/ibu, a Schedule III narcotic; one prescription for 100 tablets of hydrocodone/acetaminophen, a Schedule III narcotic; and one prescription for 6 tablets ofcialis. On August 29, 2011, one prescription for 300 tablets ofhydrocodone/ibu, a P.B. stated he/she has never consumed hydrocodone or Cialis and had no knowledge ofthe above prescriptions. Furthermore, on October 17, 2011, PRESSMAN sent an electronic mail message to P.B. entitled "my bonehead move." In part, the stated, "I am terrified about my poor judgment leading to an accusation of insurance fraud... I don't want to dig myself any deeper, but I feel like I've got to be proactive to avoid disaster. I apologize for burdening you with this, but ifyou help me out ofthis one, I will happily owe you Everything." 13. On October 18,2011, PRESSMAN telephonically contacted the BlueCross BlueShield FEHBP Retail Pharmacy Program on behalfofp.b. without P.B.'s consent or

8 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 8 of 11 PageID# 9 knowledge. In part, during the telephone conversation, PRESSMAN stated he was calling to be "proactive about dealing with it and accepting the responsibility for a real poor judgment on my part so we can rectify this." He claimed that he had made a"colossal error in judgment" and hoped to "reimburse the prescription program for everything that was laid out" and "get a running total and make good on that." Throughout the course of the telephone conversation, PRESSMAN falsely claimed that P.B. was aware of the prescriptions and that some were prescribed for P.B. because he suffered from injuries caused by an improvised explosive device. PRESSMAN claimed that the remainder ofthe medication was used "for starving adolescents" at a clinic in Afghanistan. He also claimed that he was working closely with the pharmacist at the Pentagon CVS to package and ship the medications to where they were needed. 14. Also on October 18,2011, PRESSMAN sent another electronic mail message to P.B. detailing PRESSMAN'S conversation with the BlueCross BlueShield FEHBP Retail Pharmacy Program representative. In part, the stated, "I had a good talk with the reps from blue X/blue shield and admitted my error and carelessness... I shall reimburse insurance outlay on the meds not used by you in a timely fashion. Please paint me in a favorable light -1 really am a good soul and will make an significant contribution." Furthermore, P.B. received a voic from PRESSMAN on October 18,2011. The voic stated, in part, "Hey [P.B], I just wanted to reconfirm that I spoke to the BlueCross BlueShield people again, and they just neededa verbalconfirmation from you that we talked, that you understoodthat I had made a stupid mistake, that we were rectifying the mistake, it's clearing up the confusion. I am going to cover all the expenses that insurance paid[...]. So that I don't have to go to debtor's prison, and be tarred and feathered..." On October 20,2011, PRESSMAN called BlueCross BlueShield's FEHBP Retail Pharmacy Program a second time, on behalf of P.B. without his consent or

9 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 9 of 11 PageID# 10 knowledge. During the telephoneconversation, PRESSMAN reiterated his objective for calling as previously described in the aforementioned October 18,2011 telephone conversation. In summary, PRESSMAN falsely claimed the following: that P.B. was aware that PRESSMAN was in contact with BlueCross BlueShield, that he and P.B. were involved with a special operation in which they could not find critical medications for people in "theater," that he was writing prescriptions in P.B.'s name and sending the medications to "theater," and that he wanted to make amends for some ofthe medications that were covered by insurance by paying them. 15. On March 1, 2012, B. O., a federal government employee oftfbso, provided a sworn statement and his/her Pentagon CVS prescription history to an NCIS Special Agent. The following prescriptions were written by PRESSMAN and filled in B.O.'s name: On February 4,2011, one prescription for 80 tablets ofhydrocodone/ibu, a On February 9,2011, one prescription for 60 tablets ofhydrocodone/ibu, a On February 28, 2011, one prescription for 100 tablets of hydrocodone/ibu, a On April 7, 2011, one prescription for 100 tablets ofhydrocodone/ibu, a Schedule III narcotic; and one prescription for 100 tablets of hydrocodone/acetaminophen, a On May 31, 2011, one prescription for 200 tablets ofhydrocodone/ibu, a Schedule III narcotic; one prescription for 100 tablets of hydrocodone/acetaminophen, a Schedule III narcotic; and one prescription forproventil HFA. On June 20, 2011, one prescription for 200 tablets ofhydrocodone/ibu, a Schedule III narcotic; one prescription for 100 tablets of hydrocodone/acetaminophen, a Schedule III narcotic; and one prescription for 10 tablets ofviagra. On July 22, 2011, one prescription for 200 tablets ofhydrocodone/ibu, a

10 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 10 of 11 PageID# 11 On October 11,2011, one prescription for 200 tablets of hydrocodone/ibu, a B.O. stated that he/she had never received nor requested the prescriptions written by PRESSMAN. 16. On March 2,2012, L. C, a federal government employee oftfbso and a beneficiary ofthe FEHBP, provided a sworn statement to an NCIS Special Agent. L.C. stated that on January 24, 2012, he/she received his/her prescription history from the Pentagon CVS. This history showed four prescriptions for hydrocodone, totaling approximately 600 pills, written by PRESSMAN and filled in L.C's name. L.C. stated he/she had never heard of hydrocodone and had no reason to use such a pain medication. 17. On May 18,2012, S. L., a federal government employee oftfbso, was interviewed by an NCIS Special Agent. Records provided by CVS Pharmacy show two prescriptions written by PRESSMAN and filled in S.L.'s name from the Pentagon CVS: On February 16, 2011, one prescription for 100 tablets of hydrocodone/ibu, a On March 4,2011, one prescription for 100 tablets ofhydrocodone/ibu, a S.L. stated that he/she should have had no prescription history from the Pentagon CVS, as he/she had never filled a prescription there. 18. On January 10, 2012, T.T. was interviewed by an NCIS Special Agent and a Special Agent ofthe Office ofpersonnel Management: Office ofthe Inspector General. T.T. stated that he/she met PRESSMAN while T.T. was employed as the pharmacist at the Pentagon CVS. T.T. stated that PRESSMAN often picked up prescriptions for his patients, and some of PRESSMAN'S patients were his coworkers. T.T. stated that PRESSMAN would always pay his 10

11 Case 1:12-mj TRJ Document 2 Filed 07/03/12 Page 11 of 11 PageID# 12 patients' co-pay or pay for the full cost of the prescription in cash. In addition, T.T. stated there were multiple occasions when PRESSMAN prescribed multiple prescriptions for hundreds of pills of hydrocodone to the same patient within a short amount of time. D. CONCLUSION 19. Based on the foregoing, there is probable cause to believe that during in or about January 2011 through in or about November 2011, in Arlington. Virginia, within the Eastern District ofvirginia, the defendant PETER PRESSMAN knowingly and willfully made false, fictitious, and fraudulent statements or writings in connection with the delivery of health care benefits, items, and services, within the Eastern District ofvirginia, by using the identities of fellow TFBSO federal employees, in violation oftitle 18, United States Code, Section 1028A. Specifically, the defendant knowingly and willfully used without lawful authority the means of identification of known persons, including their names and insurance data, in submitting false statements (i.e. prescriptions) to CVS Pharmacy #2712, which filled the prescriptions under the FEHBP. Sward Special Naval Cr/min/il Investigative Service Subscribed and sworn to before me on the 3rd day of July, 2012, in Alexandria, Virginia. /s/thomas Rawles Jonw, Jr. Hon. T. Rawles Jones United Slates Magistrate Judge 11