A Montana nurse practitioner used a colleague’s qualifications and fabricated claims to pull off a bold $62 million insurance scam.#Montana #MissoulaMT #News #Crime
MISSOULA, MTA: A startling fraud case in Montana left a path of dishonesty and significant financial losses in its wake. A former nurse practitioner who masterminded a bold scheme to submit more than $62 million in fraudulent insurance claims for vitamin B-12 injections that never occurred was sentenced to five years in federal prison on Friday.
In August 2024, 41-year-old Tristan Ashley Svejkovsky entered a guilty plea to charges of health care fraud and utilizing a different medical professional’s DEA registration number. According to the U.S. Attorney’s Office for the District of Montana, she was also sentenced to three years of supervised release following her jail term.
License Suspended, But the Fraud Continued
The Montana Board of Nursing suspended Svejkovsky’s nursing license on April 1, 2022. She continued to prescribe controlled medications under her own name and DEA registration number until June 2022 in spite of the suspension. She consented to give up her registration after the DEA approached her.
But rather of halting, Svejkovsky discovered a new method to continue her illicit activities. By pretending her license was just on probation, she persuaded a friend, a fellow nurse practitioner, to give her access to their DEA number. The truth was very different from Svejkovsky’s assurance to her friend that she would not abuse the information.
Svejkovsky’s legal issues were exacerbated when court documents show that she used her friend’s DEA number to write at least 28 prescriptions.
Fraudulent Claims Reach Shocking Levels
Falsified claims for vitamin B-12 injections were at the heart of the fraudulent activity, which started in August 2021. By boosting the typical dosage of a B-12 injection from one unit to an absurd 1,000 units, Svejkovsky corrupted the system. As a result, the compensation for each injection increased from about $4.88 to an incredible $4,880.
After her license was suspended, Svejkovsky continued to file claims to Blue Cross Blue Shield of Montana, backdating them to before the suspension. She further intensified her scam by May 2022, filing claims for up to $15 million every injection.
She submitted bogus claims totaling $62,310,000. Before the plan was discovered, she was paid $613,108 out of that enormous sum.
As a result of her acts, Svejkovsky was forced to pay $613,108 in reparations. The court permitted her to self-report to the U.S. Marshals Service in order to start her jail sentence, notwithstanding the gravity of her offenses.
RELATED TOPICS: Montana Crime
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