Child Support Enforcement

May 2003

In Delaware, a man was sentenced to 4 years probation and ordered to pay $164,000 in restitution for failure to pay child support. In addition, he was ordered to maintain employment.

In Nevada, a man was sentenced to 1 year probation and ordered to pay $60,000 in restitution for failure to pay child support. In addition, the man was ordered to remain current on future child support payments

In Iowa, a man was sentenced to 4 months home confinement, 5 years probation and ordered to pay $35,000 in restitution for failure to pay child support. The man, who owed almost $45,000 in overdue support, paid $10,000 prior to sentencing.

In Arkansas, a man was sentenced to 5 years probation and ordered to pay $26,000 in restitution for failure to pay child support. The man has been employed as an electrician while living in Alabama.

In Wyoming, a man was sentenced to 5 years supervised probation and ordered to pay $15,000 in restitution for failure to pay child support. A certified public accountant, he was arrested in July 2002 in Colorado.

In South Dakota, a man was sentenced to 6 months home detention, 5 years supervised probation and ordered to pay $13,000 in restitution for failure to pay child support. The man has paid $5,000 since his arrest in November 2002.

In South Dakota, a man was sentenced to 5 years supervised probation and ordered to pay $2,000 in restitution for failure to pay child support. Since his arrest in December 2002, the man has paid over $10,000 toward his arrearage amount.

In Indiana, a man was sentenced to 5 years probation and ordered to pay $49,000 in restitution for failure to pay child support. the man had not made a support payment in 5 years for his four sons. He was a former general manager of two professional indoor football teams.

Durable Medical Equipment

May 2003

In Georgia, two subjects were sentenced to serve time incarcerated and were ordered to pay restitution for their role in a scheme to defraud Medicare. From 1997 through 2002, they submitted numerous false claims to Medicare for motorized wheelchairs that were never provided to beneficiaries.

Kickbacks

May 2003

In New York, the owner of a medical lab was sentenced to 24 months incarceration and ordered to pay $284,000 in restitution for conspiracy to commit health care fraud. The owner instructed his sales representatives to pay kickbacks to doctors in return for the referral of patient specimens. In an attempt to conceal the kickbacks, the owner established shell companies for each of the sales representatives. The owner deposited money into these accounts so that the sales representatives could withdraw money and then provide cash payments to the doctors.

Misuse of Grant Funds

May 2003

In West Virginia, a woman was sentenced to 42 months incarceration and ordered to pay $302,000 in restitution for mail fraud. While employed by the West Virginia Department of Health and Human Resources, the woman embezzled more than $302,000, most of which came from Temporary Assistance for Needy Families grants.

In West Virginia, a woman was sentenced to 5 months imprisonment and ordered to pay over $40,000 in restitution for theft from an organization that received federal funds. As a payroll specialist for a HHS grantee, she embezzled approximately $40,000 by writing herself checks from the Head Start account.

Physicians and Other Health Care Professionals

May 2003

In New York, after entering a guilty plea, a psychiatrist was sentenced to a conditional discharge for his submission of false filings. The man agreed to repay $502,000 in restitution to Medicare and Medicaid for billing for office consultations and medication dispensing when no consultations actually took place.

In Wisconsin, a woman was sentenced to 33 months incarceration and ordered to pay $351,000 in restitution for health care fraud and violating the anti-kickback statute. The woman, who was previously excluded from Medicare and Medicaid due to a Medicaid fraud conviction, owned and operated staffing agencies that supplied temporary employees to nursing homes and other facilities with Medicaid and Medicare residents. The woman had a valid registered nurse’s license despite her conviction and provided some of the services herself. In addition, she bribed the schedulers in at least two nursing homes in order to obtain business.

Following a guilty plea for health care fraud, a New York man, who claimed to be a doctor, was sentenced to 4 months in federal prison and ordered to pay $233,000 in restitution. The investigation revealed that as of 1981 the man only completed six semesters in a medical program at a University in Mexico. Although he never completed medical school, he received a state medical license in 1992 using altered academic transcripts and a fake diploma. The man allegedly bribed a medical school employee to obtain the transcript and diploma.

In California, a doctor was sentenced for health care fraud and was required to surrender his medical license for billing Medicare and private insurers for diagnostic studies that never occurred. The doctor may not reapply for a 5-year period.

Prescription Drug Fraud

May 2003

In Florida, a man and his wife were sentenced for conspiracy to defraud. The man was sentenced to 60 months in prison and ordered to pay $4.9 million in restitution. His wife was sentenced to 60 months in prison and ordered to pay $4 million in restitution. The couple operated two pharmacies and participated in distributing sub-potent aerosol medication to patients. The pharmacies also sold pharmaceutical labels for medication and provided only half-portions of medications but billed Medicare for the entire amount. In another aspect of the case, a doctor was sentenced to 60 months in prison and ordered to pay $4.1 million in restitution for conspiracy to defraud. The doctor signed certificates of medical necessity and issued unnecessary prescriptions for aerosol medications for patients who were never examined. The doctor was paid $100 for each prescription by the operators of durable medical equipment companies.

In Washington, D.C., a man received a suspended sentence of 3 years incarceration for distribution of controlled substances. The case centered on a physician allegedly involved in various schemes to defraud the government and private insurance programs.

Other Cases of Interest

May 2003

In Florida, a woman was ordered to pay a $4,000 fine for causing the submission of a false claim. The woman was employed by a company that provides computer related services to Medicare carriers. The computer related services enable Medicare carriers to receive, process, adjudicate and pay Medicare claims. The woman was directed to falsify time records of various computer programmers and analysts, which in turn caused fraudulent billings to Medicare.