Knoxville Man Sentenced To 24 Months In Prison And Ordered To Repay $411,963 For Health Care Fraud Scheme

KNOXVILLE, Tenn. – On July 14, 2023, Ian P. Clarke, 43, currently of Knoxville, was sentenced to 24 months in prison by the Honorable Katherine A. Crytzer, in the United States District Court for the Eastern District of Tennessee at Knoxville.

As part of the plea agreement filed with the court, Clarke agreed to plead guilty to conspiracy to commit health care fraud, in violation of 18 U.S.C. § 1349.  Judge Crytzer ordered Clarke to pay restitution to Medicare in the amount of $411,963, and a fine of $44,258. Following his imprisonment, Clark will be on supervised release for two years.       

As set forth in the filed plea agreement, Clarke was responsible for the day-to-day operations of TN Premier Care, a medical clinic in East Tennessee.  Clarke paid kickbacks to coconspirators in exchange for signed doctors’ orders for durable medical equipment (“DME”) that was medically unnecessary.  TN Premier Care provided the DME to Medicare beneficiaries across the country who did not want or need it.  Clarke then caused the DME orders to be submitted to Medicare for reimbursement on behalf of TN Premier Care.   

The DME orders were obtained from “leads,” which consisted of a recorded call between a call-center employee or telemarketer and a Medicare beneficiary during which the beneficiary provided their Medicare information.  The recordings were provided to doctors who used the information to generate a completed DME order.  The doctors who signed the DME orders often did so regardless of medical necessity, in the absence of a preexisting doctor-patient relationship, without a physical examination, and sometimes based solely on a short telephonic conversation.  The completed DME orders were uploaded to a shared cloud-based document storage system to which Clarke had access.

To conceal the conspiracy, Clarke and his coconspirators created sham contracts and documentation to disguise the kickbacks as legitimate payments for marketing and consulting services.  Clarke also opened a separate bank account in TN Premier Care’s name for the purpose of paying kickbacks and receiving reimbursement checks from Medicare.

Between in or about July 2018 and in or about May 2019, Clarke caused the submission of approximately $778,429 in claims to Medicare for DME orders on behalf of TN Premier Care, for which Medicare paid to TN Premier Care approximately $411,963.

U.S. Attorney Francis M. Hamilton, III, of the Eastern District of Tennessee; U.S. Department of Health and Human Services, Office of Inspector General (“HHS-OIG”) Special Agent in Charge Tamala E. Miles; and Federal Bureau of Investigation (FBI) Special Agent in Charge Joseph E. Carrico, made the announcement. 

This case is the result of an investigation conducted by U.S. Department of Health and Human Services, Office of Inspector General, and the FBI. 

Assistant United States Attorney William A. Roach, Jr., prosecuted the case.

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