Child Support Enforcement

In Washington, a man pled guilty and was sentenced to 5 years probation and ordered to pay $135,000 in restitution for failure to pay child support. Since their 1991 divorce, the custodial parent has raised their five children on her own. The man worked in Texas and Colorado using an alias.

Durable Medical Equipment

An owner of a DME supply company was sentenced to 2 years imprisonment and ordered to pay $273,000 in restitution and pay a $2,500 fine for mail fraud in connection with a Medicaid fraud scheme. The man submitted claims to Wisconsin’s medical assistance program for DME that was never provided.

In Tennessee, the sales manager for a DME supplier was ordered to pay $24,000 in restitution for his role in a scheme to defraud Medicare. A joint investigation with the Federal Bureau of Investigation and the Medicaid Fraud Control Unit revealed that the manager routinely completed the clinical sections of certificates of medical necessity, falsely stating patients had qualifying conditions for alternating pressure mattresses.

Home Health Agency

In Minnesota, the last subject in a complex home health care investigation was sentenced. The woman, a director of nursing, pled guilty and was ordered to pay $53,000 in restitution for health care fraud. Through the woman’s involvement in the scheme, home health services were billed that were provided to beneficiaries who were not homebound and/or that were not medically necessary.

Medicaid Fraud

In Washington, a man was sentenced to 30 days in jail and ordered to pay $4,000 in restitution for defrauding the Medicaid program. As the State appointed guardian for his father, he continued to submit claims to Medicaid after his death.