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The strange saga of a 'misguided crusader' who got 30 months in prison for fraud


The story of Robin Hood has always been one that's struck a chord in popular culture, dating as far back as the 15th century. Rob from the rich and give to the poor? Who can't get on board with that one? (Other than the rich, of course.)

But Robin Hood is merely a folk hero. He's a character born for the purposes of sheer entertainment with heroic motivations absent of reality. In other words, Robin Hood never had to deal with the complexities of healthcare fraud litigation.

In real life, donning the Robin Hood persona doesn't work. It just doesn't mesh with the structures and laws of modern society. At least that's what a woman by the name of Joyce Crain found out last week.

Crain, a resident of Marco Island, Florida, was sentenced to 30 months in prison last week for a healthcare fraud scheme in which she forged doctors' signatures for prescription medication, falsified documents and kept more than $100,000 worth of medication in her home, which she distributed to patients, according to NBC-2. If that sounds pretty cut and dry, it's not. Crain is not your typical fraudster, and her case was not your typical fraud case.

Crain, who has been dubbed the "Robin Hood of healthcare," is no drug kingpin. Even prosecutors admitted that despite the large quantities of drugs and forged prescriptions found in a 2012 raid of her home, Crain didn't really turn a profit. She's not your typical fraudster, motivated by greed. In fact, it was just the opposite.

To understand her full story, you have to jump back to 2011. Crain, a retired registered nurse, had just founded her new nonprofit organization, Prescriptions 4 Hope. In a profile published in Naples Daily News at the time, a local woman explains how, after receiving a lung transplant, she exceeded her Medicare Part D coverage benefits. Faced with the prospect of paying for expensive medications herself, or forgoing the critical medications altogether, the woman was referred to Crain, who helped her get the drugs at a minimal cost.

This was the backbone of the business: Get medication for those in need. In the profile, Crain explains how she works with "475 drug assistance programs supplied through grants, funds, pharmaceutical and generic drug manufacturers" to find the proper medication for un- or underinsured patients. The article mentions that patients must have a valid prescription from a licensed physician.

I'm not entirely sure where things went wrong from there. Prosecutors said she ignored warnings from the state to stop dispensing medication without a license, according to Naples Daily News. My guess is that she got so fed up with the slow-moving bureaucracy of the whole process, she decided it would be easier to go rogue.

That's when things got strange. During a hearing in 2013, she compared her 2012 arrest and subsequent trial to being "raped over and over and over again," arguing the criminal charges were being "blown out of proportion." The trial itself was littered with outbursts from Crain, according to NBC-2. When given the floor at her sentencing hearing, she criticized investigators and openly questioned the judgment of the jury. She claimed a state investigator should be tried for murder since three patients had died following her arrest, an allegation the Naples Daily News could not confirm. At one point, as Assistant State Attorney Sara Hall was delivering arguments, Crain muttered profanities at her from the defendant's table.

In the end, Lee Circuit Judge Ramiro Mañalich called the case "pretty unique and perplexing," but admitted that Crain could not be characterized as your run-of-the-mill drug dealer. Although prosecutors pushed for the eight-year minimum sentence by painting Crain as a criminal mastermind likely to reoffend, the judge opted for just 30 months, calling her a "misguided crusader."

Judge Mañalich nailed it. If there was ever a reason to dip below the minimum sentencing--in this case, well below--this was it. Crain clearly did not set out to get rich selling prescription drugs. What she wanted more than anything was to help those in need. Although it's an admirable motivation, in her mind it gave her a free pass to leapfrog whatever laws stood in her way.  

"It was not to defraud. It was not to deflect. It was not to do any of that," Crain testified when asked about the prescription drugs seized from her home. "It was to make sure I got the medication so that it got to the patient."

In some ways, you have to feel for Crain. She truly believed that the end justified the means, that her altruistic motivations would become clear to the jury, absolving her of any petty transgressions. In her mind, it was the system that was corrupt. Those pesky laws merely served as an impediment to getting desperate patients their necessary medication. She never saw herself as a criminal--and something tells me she never will.

But that's why Robin Hood exists as folklore. Perhaps fraud and forgery laws didn't exist in Sherwood Forest, but it seems they are alive and well in Florida. - Evan (@HealthPayer)

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