legal representation for DOJ investigations

Home/Tag: legal representation for DOJ investigations

Woman Posing as Nurse For Six Years Sentenced to Prison For Health Care Fraud, Identity Theft, and Wire Fraud

 

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Medical lawsuit. Arrest for medical crime concept. Handcuff near stethoscope on blue background top view.On September 23, 2020, a Tennessee woman who posed as a nurse working at several medical facilities was sentenced to more than four years in prison. In December 2019, she pled guilty to wire fraud, healthcare fraud, identity theft, and practicing nursing without a license.

How a Phony Nurse Gained Employment.

According to a news release from the U.S. Attorney’s Office, the woman posed as a registered nurse, despite not having a nursing degree or a nursing license, and having no nursing experience. To accomplish the fraud, she obtained the license numbers of real nurses with similar first names. She admitted to providing fraudulent information on job applications to gain employment. She was employed by at least eight different health care providers between September 2012 and November 2018. She also falsely claimed that she held nursing degrees from two educational institutions, Walters State College and Carson Newman University.

This is a long time, six years, to get away with health fraud. Usually, we only see things like this in Florida. However, in the past few years, Florida seems to be seeing fewer and fewer fake doctors, nurses, and health professionals. Perhaps the crackdown by the Florida Department of Health on the unlicensed practice of health professions has had some impact on this.

Continuing Lies & Fraudulent Behavior.

While posing as a nurse, the fake R.N. worked in various medical settings, including nursing homes, rehabilitation and assisted living facilities, a doctor’s office, and home health agencies. She rendered nursing care to numerous patients, dispensed prescription medications, and gained access to patients’ sensitive and private medical information, the U.S. Attorney’s Office said. Furthermore, the woman made false entries in patients’ medical records and submitted or caused the submission of at least $500,000 in false claims to public and private health care benefit programs.

The phony nurse performed procedures that she was, of course, unqualified to perform. She failed to act or to notify others of the necessary procedures for patients and failed to chart and document patient care. According to the written plea agreement, at least one patient required re-admittance to the hospital and an additional three-day hospital stay due to her inept care.

The Tennessee Bureau of Investigation Director David Rausch is quoted in the media as having stated: “Our Medicaid Fraud Control Division remains committed to working with our federal partners to ensure healthcare fraud and identity theft cases like this one are addressed and investigated thoroughly.”

Judge Clifton L. Corker of the U.S. District Court for the Eastern District of Tennessee sentenced her to 51 months in prison, followed by three years of supervised release. She was also ordered to repay $700,000 in restitution to her employers.

To read the DOJ’s press release about this case in full, click here.

To read about a similar case in Florida, click here to view one of my prior blogs.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists, and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.
To contact The Health Law Firm, please call (407) 331-6620 or (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Morristown woman posed as nurse for 6 years at 8 health care providers.” ABC 6 Local News. (December 12, 2019). Web.

Starks, Ariel. “Fake nurse sentenced to 51 months in prison, ordered to repay employers $700,000.” WVLT 8 Local News. (September 23, 2020). Web.

Bonvissuto, Kimberly. “Nurse imposter who worked in assisted living sentenced for wire fraud, healthcare fraud, identity theft.” McKnight’s Senior Living. (September 25, 2020). Web.

Headshot of The Health Law Firm's attorney George F. Indest IIIAbout the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

KeyWords: nursing license defense attorney, legal representation for nursing license defense, legal representation for board of nursing complaints and investigations, unlicensed practice of medicine defense attorney, unlicensed practice of nursing defense lawyer, Department of Health defense attorney, DORA investigation defense lawyer, legal representation for DOH or DORA investigations, DOJ defense lawyer, legal representation for DOJ investigations, legal representation for nurses, health law attorney, nursing law attorney, health care fraud defense attorney, legal representation for health care fraud, legal representation for health care fraud investigations, health care fraud investigation representation, legal representation for U.S. Department of Justice (DOJ) investigations, DOJ investigation representation, Medicare fraud defense lawyer, Medicaid fraud defense attorney, representation for Medicare and Medicaid fraud, representation for false billing, representation for submitting false claims, False Claims Act (FCA) defense attorney, FCA legal representation, FCA investigation representation, representation for FCA investigations, review of The Health Law Firm attorneys, The Health Law Firm reviews, Medicaid Fraud Control Unit (MFCU) defense attorney

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

3 Sentenced in Florida for $175 Million Drug Compounding Fraud Scheme

11 Indest-2008-8By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On March 24, 2017, three participants were sentenced in Florida federal court, for a scheme that used call centers and kickbacks to generate fake prescriptions for compounding pharmacies. The scheme was able to scam the government and private insurers for $175 million.

U.S. District Judge Daniel T.K. Hurley, sentenced one of the defendants, Todd Stephens, to ten years. He sentenced Todd Hanson to eight years and one month. He sentenced Christopher Mucha to 30 months in prison. Each defendant also received three years of supervised release (probation) after they are released from prison.

Illegal Enterprise.

Stephens, Hanson and Mucha were among 16 defendants the federal government charged in September 2016. The U.S. Department of Justice (DOJ) described an extensive enterprise that operated from 2013 to 2015. According to the DOJ, the enterprise controlled numerous stops along the supply chain, including the selection of ingredients for compounded drugs, solicitation of patients for unnecessary prescriptions, and funneling of kickbacks to “corrupt physicians.”

To learn more about the defendants being charged, click here.

According to prosecutors, the participants purchased pharmacies that functioned as fronts for the illegal conduct and held licenses that made the operation possible. Specific drugs were chosen and produced by the pharmacies based on the amount of money reimbursed by the military health care program TriCare, as well as other private insurers. More than $175 million was eventually paid out in false claims, prosecutors alleged.

Key Component of the Scheme.

The defendants used call centers as a major part of the scheme to generate bogus prescriptions. The call center staff obtained information on potential patients, including military veterans, who had previously been prescribed medications. They then proceeded to contact the patients to convince them to authorize the faxing of the medically unnecessary prescriptions to doctors’ offices.

A group of “corrupt” physicians would then issue prescriptions for compounded medications for the patients regardless of the absence of medical necessity. It was alleged that this was done in exchange for illegal compensation to the doctors such as cash, gift cards and free consulting. The defendants disguised the illegal payments as reimbursement for “data collection.” These were allegedly distributed through a phony software company called ClinicalCorp LLC, prosecutors said.

To read the sentencing memorandum in full, click here.

To read about a similar health care fraud case involving TRICARE, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Representing Pharmacists, Pharmacies, and Other Health Care Providers.

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes pharmacists, pharmacies, physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

To contact The Health Law Firm, please call (407) 331-6620 or visit our website at www.TheHealthLawFirm.com.

Sources:

Hale, Nathan. “3 Sentenced In Fla. For $175M Health Care Fraud Scheme.” Law360. (March 24, 2017). Web.

McMahon, Paula. “Feds charge 16 in massive $175M prescription cream fraud based in South Florida.” Sun-Sentinel. (September 1, 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for allegations of violating Anti-Kickback Statute, TRICARE false claims legal defense attorney, TRICARE physician representation, pharmaceutical fraud lawyer, compounding pharmacy attorney, legal representation for military physicians, fraudulent practices of pharmaceutical companies, financial interest in physician referrals, TRICARE fraud attorney, compounding pharmacy lawyer, legal defense of military physicians, legal defense of TRICARE providers, attorney reviews of The Health Law Firm, Veterans Administration (VA) physician defense attorney, The Health Law Firm attorney reviews, Health care fraud defense attorney, legal representation for health care fraud, legal counsel for allegations of health care fraud, AKS defense attorney, False Claims Act (FCA) defense attorney, legal representation for FCA claims, legal representation for illegal kickback schemes, health care fraud defense lawyer, health care fraud scheme, legal representation for DOJ investigations, DOJ investigation defense attorney

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

Go to Top