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Sunday, December 22, 2024

Former nurse practitioner admits healthcare fraud involving false claims totaling nearly $600K

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U.S. Attorney Jesse A. Laslovich | U.S. Department of Justice

U.S. Attorney Jesse A. Laslovich | U.S. Department of Justice

A former nurse practitioner in Butte admitted on Thursday to prescribing controlled substances despite having a suspended license and falsely billing an insurance company approximately $61 million for vitamin B-12 injections, receiving nearly $600,000 from the false claims, U.S. Attorney Jesse Laslovich announced.

The defendant, Tristan Ashley Svejkovsky, 40, pleaded guilty to health care fraud and using a registration number issued to another person. Svejkovsky faces a maximum of 10 years in prison, a $250,000 fine, and three years of supervised release on the health care fraud charge. She also faces up to four years in prison, a $250,000 fine, and one year of supervised release for using another person's registration.

U.S. Magistrate Judge Kathleen L. DeSoto presided over the proceedings. Sentencing is set for Dec. 12 before U.S. District Judge Dana L. Christensen. The court will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors. Svejkovsky was released pending further proceedings.

According to court documents, Svejkovsky's nursing license was suspended by the Montana Board of Nursing on April 1, 2022. Despite this suspension, she continued to prescribe controlled substances using her own name and Drug Enforcement Administration (DEA) registration number until June 8, 2022. The DEA contacted Svejkovsky through her attorney, leading her to voluntarily surrender her DEA registration.

However, Svejkovsky then used the name and DEA registration number of a friend who was also a nurse practitioner to continue prescribing controlled substances. She misrepresented her status to her friend by claiming that her nursing license was on probation rather than suspended and assured that she would not use her friend's information for prescriptions. In reality, she used this information for at least 12 prescriptions of controlled substances.

Further allegations state that Svejkovsky billed Blue Cross Blue Shield of Montana for vitamin B-12 injections that never occurred. Beginning in August 2021, she falsely increased the units per injection from one unit to 1,000 units which raised the payment per injection from approximately $4.88 to $4,880 from the insurance company.

After her license suspension in April 2022, Svejkovsky submitted numerous backdated claims each month to Blue Cross Blue Shield of Montana as if they were made before her suspension date. This fraudulent activity continued until May 2022 when she submitted four claims totaling $15 million per vitamin B-12 injection for a new patient who never received any injections.

In totality, Svejkovsky billed at least $61 million for these false vitamin B-12 injections and received approximately $593,583 from these claims.

The case is being prosecuted by the U.S. Attorney’s Office with investigations conducted by both the DEA and FBI.

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