(Explore Clarion - EYT) – A criminal conference is scheduled for next week for a nurse practitioner accused of insurance fraud.
Court documents indicate a criminal conference for 59-year-old Eugene John Lewis, of Leeper, has been scheduled for Wednesday, January 11.
According to court documents, the following charges against Lewis were ordered waived for court during a preliminary hearing on Monday, October 24:
– False/Fraud/Incomp Insurance Claim, Felony 3
– Theft By Deception-False Impression, Misdemeanor 1
– Procure For Self/Other Drug By Fraud, Misdemeanor
His case was transferred to the court of Common Pleas.
Details of the case:
Your Affiant, who has been employed as a Special Agent for the Pennsylvania Office Attorney General, Insurance Fraud Section, Western Regional Office, since February 2016, and has been a police officer in this Commonwealth since 1998, is the case agent assigned to the investigation involving the Actor, Eugene Lewis, Jr.
This investigation was initiated by the Western Regional Office of the Insurance Fraud Section of the Office of Attorney General based upon a referral of information to this office by Cuno Anderson, Jr., Senior Consultant of Investigations, National Anti-Fraud Department, Special Investigations Unit from Blue Cross Blue Shield Insurance Company. The investigation revealed that the Actor is a Certified Registered Nurse Practitioner (“CRNP”) employed by the Department of Veterans Affairs (“VA”) in Butler, Butler County. He resides at 113 Briar Lane, Leeper, Farmington Township, Clarion County, PA.
The Actor was arrested on June 27, 2022 for false or fraudulent prescriptions. In this investigation, the Actor furnished false documentation to CVS Pharmacy in Clarion County, PA in an attempt to obtain prescription medication. The fraudulent prescription was issued to Ann Twentier, a Registered Nurse who is also employed at the Butler VA.
Based on that arrest, Cuno Anderson, Jr., conducted an audit of all prescriptions issued by the Actor. The audit revealed the Actor had issued numerous prescriptions to himself and Ann Twentier that were filled and paid for using Blue Cross Blue Shield Insurance.
Anderson, Jr. indicated that Twentier is not a patient and could not be a patient of the VA since she is not a veteran and did not serve in the Armed Forces. Anderson, Jr. stated that all the prescriptions issued to Twentier and the Actor himself should not have been paid for by Blue Cross Blue Shield.
Your Affiant conducted a review of the prescriptions the Actor issued and found, between November 20, 2018 and November 28, 2021, the Actor issued or called in to the pharmacy 58 prescriptions, 55 for himself and three (3) for Ann Twentier. All of them were purchased utilizing CVS Caremark, which is the third-party prescription administrator for Blue Cross Blue Shield Insurance.
Blue Cross Blue Shield Insurance paid a total of $890.62 for the 58 prescriptions.
On August 23, 2022, Your Affiant received and reviewed records provided by CVS Caremark which provided the following information:
1. On August 9, 2022, Your Affiant submitted an official request to Blue Cross BILie Shield and CVS Caremark for detailed records of all prescriptions the Actor issued and later filled using Blue Cross Blue Shield insurance.
2. CVS Caremark is the third-party administrator for all prescriptions utilizing Blue Cross Blue Shield insurance
3. On August 23, 2022, Allison Johanson from CVS Caremark provided two (2) documents consisting of 131 pages
4 Your Affiant reviewed the documents that revealed the Actor wrote himself 55 prescriptions from November 20, 2018 to November 28, 2021, which were dispensed at two (2) pharmacies in Pennsylvania: (i) the CVS Pharmacy located at 700 Main Street in Clarion PA and (ii) the CVS Pharmacy located at 1805 Wilmington Road in New Castle, PA.
5 Twelve (12) of the prescriptions were for a Schedule V controlled Substance, and the remaining prescriptions were for non-Controlled Substances that required a prescription.
6. The Actor issued three (3) prescriptions to Ann Twentier (Drushel), one (1) being on October 1, 2020 and two (2) on August 12, 2021 They were all filled at the same pharmacy using Blue Cross Blue Shield insurance.
7. The prescriptions issued to Twentier were non-Controlled Substances that required a prescription.
8. The Actor issued 58 prescriptions that were later paid for by Blue Cross Blue Shield Insurance, totaling $890.62.
C. On September 14, 2022, Your Affiant received and reviewed records provided by T’rese M. Evancho, Prosecuting Attorney, Office of Chief Counsel, PA Department of State, which provided the following information:
1. On August 9, 2022, Your Affiant submitted an official request to T’rese M. Evancho for all Collaborative Agreements involving the Actor.
2. On August 14, 2022, Your Affiant received and reviewed a response thereto.
3. The Pennsylvania State Board of Nursing documents indicate the Actor first had a Collaborate Agreement for Prescriptive Authority with Doctor Richard Brown in September of 2004.
4. This Agreement indicates the Actor was , at that time, employed with the Veterans Administration
5. The Actor and Doctor Richard Brown submitted a change in Prescriptive Authority on December 16, 2009 with an effective date of January 1, 2010.
6 This modification only applied to Change in Controlled Substance Schedule(s) or Timeframe(s).
7. On November 16, 2019 and November 17, 2019, respectively, an Application for CRNP Prescriptive Authority and Collaborative Agreement between the Actor and Doctor Jonathan Morrow Urffer was submitted to the State Board of Nursing with a requested effective date of December 1, 2019.
8. The PA State Board of Nursing indicates the Prescriptive Authority issue date was Mays, 2020 with an expiration date of April 30, 2023.
D. On September 27, 2022, Your Affiant and Narcotics Agent Stephanie McElhaney conducted an interview with Doctor Jonathan Morrow Urffer at the Veterans Administration Healthcare Facility in Butler, PA, who provided the following information:
1 Urffer was advised of the investigation involving the Actor, and agreed to answer questions concerning the Actors Collaborative Agreement and Prescriptive Authority
2 Urffer agreed he signed the Collaborative Agreement with the Actor on November 20, 2019
3. Urffer advised the Actor was an in-home specialist and worked within patients’ residences and not at the medical facility.
4. Your Affiant asked Urffer if he conducted periodic reviews of the Actor’s patient files and prescriptions the Actor dispensed to patients. Urffer stated he reviews the Actor’s patients’ charts as required by the VA Healthcare rules and regulations. Urffer added that he also conducts reviews of patients’ treatments when the Actor is off work or on leave since he cares for the patients during those times
5 Your Affiant asked Urffer if he is employed with any other hospital or medical facility. Urffer stated he is only employed by the VA.
6. Your Affiant asked Urffer if he is treating the Actor as a patient or if the Actor has ever been a patient of his or the VA. Urffer stated the Actor is not his patient and has never been his patient.
7. Your Affiant asked Urffer if he has ever given the Actor permission to prescribe himself prescription medication. Urffer stated he did not
8. Your Affiant asked Urffer if he had knowledge the Actor was prescribing himself prescription medication. Urffer stated he did not.
9. Urffer agreed that the Actor prescribing himself prescription medications would be against the rules and
regulations of the VA and would not be covered under his Prescriptive Authority agreement.
E. On October 4, 2022, Your Affiant and Narcotics Agent Stephanie McElhaney conducted an interview with the Actor in the presence of his counsel, who provided the following information:
1. The Actor was advised of the investigation, and agreed to cooperate and answer any questions.
2. The Actor agreed that, while working for the VA as a CRNP, he had a collaborative agreement with Doctor Jonathan Morrow Urffer.
3. Your Affiant presented the Actor with a signed copy of the Collaborative Agreement, which the Actor agreed he signed and dated on November 16, 2019 and it was later signed by Dr. Urffer on November 19, 2019.
4. Your Affiant then advised the Actor that the investigation revealed he had called in to several pharmacies a total of 55 prescriptions to himself and three (3) in the name of Ann Twentier between November 20, 2018 and November 28, 2021. The Actor stated he did, in fact, call in the prescriptions to the pharmacies.
5. Your Affiant asked the Actor if he utilized his Blue Cross Blue Shield Insurance to pay for these prescriptions. The Actor stated he did.
6. Your Affiant asked the Actor if he was a patient of Dr. Urffer or the VA The Actor stated he was not.
7. Your Affiant asked the Actor if he was ever given permission from Dr. Urffer to prescribe himself medications. The Actor stated he never asked, and was never given permission
8 The Actor indicated he was unaware he could not write himself or Twentier prescriptions. Your Affiant advised the Actor that, under the law in the Commonwealth of Pennsylvania, a collaborative agreement with prescriptive authority only gives the CRNP the ability to write prescriptions to the patients covered by the physician assigned/indicated within the agreement or the medical facility at which the CRNP is employed.
9. The Actor stated he was working over a hundred hours per week for the VA, and was having some health issues. He took it upon himself to prescribe the medications. He has since contacted and been under the care of a primary care physician.
10. The Actor indicated he was solely responsible for the prescriptions he called in to the pharmacies, and used his Blue Cross Blue Shield Insurance to pay for them.
Based upon the information set forth above, Your Affiant believes there is probable cause for the issuance of an arrest warrant for the Actor, Eugene J. Lewis, Jr.
The Pennsylvania Attorney General’s Office filed charges against Eugene John Lewis, 59, of Leeper, and Ann M. Twentier, 53, of Portersville, on June 27 at Magisterial District Judge Duane L. Quinn’s office.
The investigation was initiated after a suspicious prescription was received by CVS Pharmacy in Clarion on December 18, 2021.
By Jacob Deemer
January 2, 2023
