June 2006 Criminal Enforcement Report

Archive Criminal Enforcement Archive

Home Health Agency

In Virginia, a woman was sentenced to 2 years probation for making a false statement related to a health care benefit program. The woman falsely certified that personal care aides received 40 hours of training when, actually, most of them received 10-15 hours of training or no training at all. The false certificates resulted in numerous false claims being submitted to the Virginia Medicaid program.

Practitioners

In Ohio, a pain management physician, who was previously convicted in a jury trial, was sentenced to life imprisonment for health care fraud that resulted in the death of two patients. The physician was also sentenced to additional jail time totaling 20 years for illegal drug distribution, mail fraud, wire fraud and health care fraud. If the life sentence is overturned, he will be subject to supervised release and deportation. The investigation revealed that the doctor gave painful trigger-point injections to patients in exchange for prescriptions for narcotic drugs. In turn, the doctor submitted claims to health care benefit programs falsely indicating that he performed a more complex procedure such as nerve block or epidural injections. Many of the patients endured the painful treatments because they were addicted to drugs while other patients, who initially had legitimate injuries, fell victim to the physician’s scheme and became addicted to drugs.

In Ohio, a podiatrist was sentenced to 5 months incarceration, 5 months home detention and ordered to pay $120,000 in restitution for health care fraud. The podiatrist billed Medicare and Medicaid for performing surgical procedures on patients when she actually only provided routine foot care.

Child Support Enforcement

In West Virginia, a man was sentenced to 12 months imprisonment, 1 year of supervised release and ordered to pay $76,000 in restitution for failure to pay child support. For three years, the man avoided arrest and prosecution by moving around the country. In November 2005, the U.S. Marshal’s Service arrested the man in Louisiana.

In Louisiana, a man was sentenced to 8 months home confinement, 4 years probation and ordered to pay $24,500 in restitution for failure to pay child support. The investigation revealed that the man frequently moved, changed jobs when wage garnishments were in place, and used his new wife’s name to open up a business in order to avoid paying his support obligation. The man and his new wife have four children who attend private school while his son in Louisiana received public assistance.

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