Neligh woman sentenced for health care fraud

NELIGH, Neb. -- After being convicted of health care fraud, a Neligh woman was given prison time.

Acting U.S. Attorney Susan Lehr said 49-year-old Danelle Charf, of Neligh, was sentenced in federal court in Omaha on Nov. 20. She was convicted for making a false, fictitious, and fraudulent statement in connection with health care services. Charf will serve two months in prison with a three-year term of supervised release after. There is no parole in the federal system. Charf has to pay $573,337.53 in restitution to Medicare and Medicaid.

Court document state the Charf previously owned Wanek Pharmacy in Neligh, and Tilden Pharmacy in Tilden. Agents started investigating in fall 2020 after receiving a tip. Multiple current and former employees were interviewed by investigators. Pharmacists and pharmacy technicians who worked at the Wanek and/or Tilden Pharmacies reported that Charf was responsible for changing orders from suppliers so that brands were commonly unavailable.

Officials said the witnesses confirmed the complainant’s report that the pharmacies were billing for name brand while giving generic medications. Employees also reported that Charf was submitting claims for prescriptions where the pharmacy anticipated that the prescription would not be filled by the customer and had not, in fact, been filled.

Investigators said they chose some beneficiaries at random to interview and found beneficiaries who had been prescribed a name brand medication but were given a generic medication. They were able to photograph the medications with name brand prescription labels placed on generic medications.

According to authorities, an invoice review was done where they compared all of the claims submitted to Medicare and Medicaid by Wanek and Tilden Pharmacies to how much of the same drugs were ordered by the pharmacies during the same time period. Even excluding claims to private insurance companies, the reconciliation showed that Wanek did not have adequate purchases to support their claims for 1,032 of the 3,676 drugs reviewed, resulting in a loss of $369,837.38. Tilden did not have adequate purchases to support their claims for 612 of 1737 drugs reviewed, resulting in a loss of $203,500.15.

This case was investigated by the HHS Office of Inspector General and Nebraska Attorney General Office.