Durable Medical Equipment

In Indiana, a woman was ordered to pay $460,000 in restitution for health care fraud. As a billing clerk at a DME supplier, the woman routinely billed Medicaid for more items than were actually provided. In addition, the woman’s parents have entered guilty pleas for their involvement in the scheme and are scheduled to be sentenced in October 2004.

In Florida, a DME company owner was ordered to pay $54,000 in restitution for false claims. The woman billed Medicare for wheelchairs but actually provided patients with less expensive scooters.

Physicians and Other Health Care Professionals

An Illinois doctor and her employee were sentenced for their role in submitting false claims. The doctor was sentenced to 5 months incarceration and ordered to pay $70,000 in restitution; the employee was ordered to pay $7,500 in restitution. Claims submitted were for psychiatric services provided when the doctor was absent from the office and/or were actually provided by the employee, who has never been licensed to practice medicine.

Prescription Drug Fraud

In North Carolina, an operating room nurse was sentenced to a 5-month suspended sentence and ordered to pay $15,000 in restitution for her role in fraudulently obtaining controlled substances. The woman provided prescription pads to a group of drug dealers who would in turn obtain controlled substances and return a portion of the drugs to her to sustain her drug addiction.

In Washington, D.C., a man was sentenced to 270 days incarceration with credit for time served for obtaining controlled substances by fraud and for escaping from an institution. The man used the identities of two physicians to write prescriptions for controlled and non-controlled substances. Most of the prescriptions were written on stolen or fabricated prescription pads from a hospital. Also sentenced this month was a Government contractor for using his insurance to pay for some of the fraudulent prescriptions.