Durable Medical Equipment

December 2003

In Indiana, a woman was sentenced to 51 months imprisonment and ordered to pay over $1.9 million in restitution for health care fraud, mail fraud and for unlawful kickbacks. In addition, she is currently undergoing criminal forfeiture of her assets, including a $1 million home and assets of two related businesses. The woman was the president/owner of a DME and pharmaceutical supplier that billed Medicare, Medicaid, and Tri-Care for injectible solutions, IV therapies, and other selected services and supplies in highly excessive quantities. She often billed for more supplies in a week than patients could use in a year.

In Florida, two remaining subjects were sentenced related to various charges for their role in a DME fraud scheme. The mastermind of the conspiracy was sentenced to 87 months in prison, and the other defendant was sentenced to 53 months in prison. In addition, they were ordered to pay over $1.7 million in restitution, jointly and severally with other co-defendants. The subjects involved in the scheme defrauded the Medicare program in connection with approximately $5 million worth of fraudulent claims for the cost of power wheelchairs and accessories that were allegedly supplied by two companies.

Physicians and Other Health Care Professionals

December 2003

In Utah, a nurse practitioner was ordered to pay almost $3,000 in restitution for false claims and aiding and abetting. From 1994 until her clinic closed in April 2001, the woman submitted claims for services she provided using the names and personal identification numbers of physicians not associated with the clinic.

In South Dakota, a woman was ordered to perform 80 hours of community service for false statements relating to health care matters. In addition, she was ordered to write a letter of apology to the members of an Indian reservation. The woman was charged pursuant to an OIG investigation into alleged substandard care provided at a facility resulting in the deaths of seven patients from the Indian reservation during a 6-month period. The woman, who was the facility charge nurse, routinely altered patient records and shredded, or ordered to be shredded, patient care records to conceal life-threatening treatment errors. She also documented patient files for medications not given.

Employee Misconduct

December 2003

In Maryland, a former NIH scientist was sentenced to 18 months incarceration for knowingly receiving child pornography. In addition, the man must participate in a mental health treatment program, register as a sex offender, and not access a computer or the Internet without prior approval from the Division of Probation.