Child Support Enforcement

June 2003

In Ohio, a man was sentenced to 4 years probation and ordered to pay $54,000 in restitution for failure to pay child support for his three children. In July 2002, the Lorain County grand jury indicted the man, and he was later arrested in Maine. The man is currently serving an 18-month sentence as a result of his failure to abide by the terms of a 1992 conviction for failure to pay child support.

In Arkansas, a man was sentenced to 5 years probation and ordered to pay $41,000 in restitution for failure to pay child support. The man admitted that he had lived in at least 10 different states during the past 3 years in his attempt to avoid arrest.

In Puerto Rico, a man was sentenced to 5 years probation and ordered to pay $30,000 in restitution for failure to pay child support. The man attributed his failure to pay to an addiction to controlled substances.

In South Dakota, a man was sentenced to 10 months incarceration, 1 year supervised release and ordered to pay $23,000 in restitution for failure to pay child support. The man was indicted in October 2002 after failing to pay toward his obligation since 2000.

In Ohio, a man was sentenced to 5 years probation and ordered to pay almost $23,000 in restitution for failure to pay child support. In 1993, the man was ordered to pay approximately $300 a month for his two children. The man, who lives in Arizona, only made a few sporadic payments since 1998.

In South Dakota, a man was sentenced to 5 years supervised probation and ordered to pay $18,000 in restitution for failure to pay child support.

In South Dakota, a woman was sentenced to 6 months home confinement with 2 months electronic monitoring, 5 years supervised probation and ordered to pay $12,000 in restitution for failure to pay child support. The woman was indicted in August 2002 after failing to make any support payments since 1998.

Durable Medical Equipment

June 2003

In Texas, a man was sentenced to 12 months and 1 day incarceration and ordered to pay $385,000 in restitution, jointly and severally with his wife. As owners and operators of a durable medical equipment (DME) company, the couple billed Medicare for DME that was never provided. In addition, the couple began billing Medicare through a different DME company after they realized that the company was being investigated.

In California, a man was sentenced to 24 months in prison and ordered to forfeit $856,000 in cash and a $735,000 house for health care fraud. The man along with his co-conspirators billed Medicare for over $4 million worth of durable medical equipment that was either never provided or provided without a valid prescription from a physician.

Misuse of Grant Funds

June 2003

In Michigan, a woman was sentenced to 2 years incarceration and ordered to pay $1 million in restitution for mail fraud. The woman fraudulently used grant funds provided by Temporary Assistance for Needy Families and the Child Care and Development Fund intended for operating day care facilities. During the investigation, it was determined that claims submitted were for the care of children that were not in the center at the time indicated.

Physicians and Other Health Care Professionals

June 2003

An Ohio podiatrist was ordered to pay $65,000 in fines and restitution for false statements related to health care matters. Not only did the podiatrist utilize multiple fraudulent billing schemes, but he also forged documents to conceal the fraud. In addition, the podiatrist, who patented a boot-like device, went to several nursing homes to conduct studies on the device and while there, stole Medicare and Medicaid numbers to submit fraudulent billings.

In Virginia, a woman was sentenced on three charges relating to her diverting controlled substances for her own personal use. She was sentenced to 30 days incarceration for each count and ordered to pay a $5,000 fine. The woman was a certified registered nurse anesthetist and was concurrently licensed/certified in at least 14 different states. This enabled the woman to provide temporary anesthesia services throughout the country with the ability to move freely from one job to another. By the time her addiction related behavior was discovered, the nurse was able to gain new temporary anesthesia assignments and carry-on with her addiction. The woman, who had a 20-year history of being addicted to drugs, repeatedly used false statements to cover up her past disciplinary actions and arrests relating to theft of controlled substances.

In New York, a billing clerk was ordered to pay $2,100 in restitution for health care fraud. The billing clerk systematically upcoded claims. These claims had already been upcoded by nurses who routinely treated patients without any physician involvement, but coded the services as though a physician had rendered them.

Prescription Drug Fraud

June 2003

In Florida, the owner of a pharmacy was sentenced to 60 months in prison and ordered to pay almost $3.3 million in restitution for conspiracy to defraud. The pharmacy owner participated in distributing sub-potent aerosol medication for patients from a clinic. The pharmacist 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 woman was sentenced to 51 months in prison and ordered to pay $3.5 million in restitution for laundering fraudulent proceeds obtained through various schemes to defraud Medicare.

An Illinois pharmacist was ordered to pay $30,000 in restitution for his role in the theft and distribution of the drug Serostim. The drug was stolen from an AIDS clinic, then sold on the “black market” to bodybuilders. In addition, the pharmacist agreed to give up his license for 4 years.

In Georgia, a woman was sentenced to 10 months in jail and ordered to pay $11,000 in restitution for her involvement in the acquisition and distribution of OxyContin.

Ambulance Companies

June 2003

In Pennsylvania, a man was sentenced to 32 months incarceration and ordered to pay $111,000 in restitution for embezzlement. As president of a non-profit volunteer ambulance company, the man embezzled funds through a scheme that was discovered during an investigation into allegations of Medicare fraud.

Employee Misconduct

June 2003

In New Mexico, a woman was ordered to pay over $9,000 in restitution for embezzlement. From January 2001 through July 2001, while serving as a procurement officer for the Indian Health Service, the woman used her government IMPAC credit card to make personal purchases.

Other Cases of Interest

June 2003

In Oregon, a man was ordered to pay $6,000 in fines and restitution for false statements relating to health care and Social Security fraud.