/>iHeadlines that Matter for Companies and Executives in Regulated Industries
Nurse Pleads Guilty to Health Care Fraud, Distributing Controlled Substances
On May 9, 2023, an advanced practice registered nurse pleaded guilty to unlawfully distributing controlled substances and committing health care fraud.
Court documents reflect that the nurse operated Convenient Care Clinic in Tennessee and was authorized to prescribe controlled substances pursuant to a registration from the US Drug Enforcement Agency (DEA). The government alleges that the nurse had sexual relationships with two of her patients. Additionally, the nurse is accused of prescribing controlled substances outside of her professional medical practice, without a legitimate medical purpose, and continued to do so even after one of her patients, to whom she prescribed controlled substances, fatally overdosed. According to court documents, the nurse also billed Medicare and Medicaid for services that she did not personally provide. As a result, Medicare and Medicaid paid the nurse approximately $16,234 for services that she did not render.
The nurse pleaded guilty to two counts of unlawful distribution of controlled substances and one count of health care fraud. She is scheduled to be sentenced on October 3, 2023.
The US Department of Justice (DOJ) press release can be found here.
Michigan Doctor Sentenced for $2 Million Health Care Fraud Conspiracy
On May 4, 2023, a podiatrist in Michigan was sentenced to seven years in prison for fraudulently billing Medicare almost $2 million under a false identity.
Court documents reflect that the doctor owned and operated a podiatry practice in Michigan, But he had been suspended by Medicare for suspicious billing practices, making him ineligible to receive any Medicare funds. Despite this, the doctor created a new entity and convinced another doctor, who was eligible to bill Medicare, to enroll in the Medicare program. The defendant then used the other doctor’s name on corporate and financial documents relating to the new entity and submitted bills to Medicare, fraudulently indicating that the other doctor provided the services to patients. This scheme allowed the defendant to bill Medicare through the new entity for almost $2 million in false or fraudulent services.
After the doctor was indicted, Medicare suspended the new entity from receiving any Medicare funds. The defendant then allegedly interfered with the government’s investigation and case against him by falsifying statements, including forging at least one signature on a letter sent to the US Department of Health and Human Services.
The DOJ press release can be found here.
Sustainable Fuel Company Founder Charged with Embezzling $5.9 Million
On May 4, 2023, the founder and former CEO of a sustainable fuel company was indicted by a Washington, DC, federal grand jury for his involvement in a multi-million dollar embezzlement scheme.
According to court documents, the founder allegedly defrauded the company by both making unapproved personal purchases from a company bank account and deceptively transferring company funds to a personal bank account. Additionally, he tried to cover up the embezzlement by providing a company accountant and members of the company’s board with fraudulent financial records, including falsified bank statements. The government claims that the founder used these embezzled funds to buy a variety of personal items, including a Range Rover, a vintage Mercedes-Benz sports car, fees to a private beach club, and payments towards personal residences.
The founder is charged with three counts of wire fraud and two counts of engaging in monetary transactions in property derived from specified unlawful activity.
