A federal jury in Covington has convicted Andrea Almond, a 48-year-old chiropractor from Cincinnati, Ohio, of conspiracy to commit health care fraud in connection with her ownership of the Newport Chiropractic Center in Newport, Ky.
The verdict, delivered late Friday afternoon after four days of trial and six hours of deliberation, stems from a scheme involving tens of thousands of dollars in payments from the Kentucky Medicaid Program.
According to evidence presented at trial, from September 2008 through April 2010, Almond conspired with a co-defendant, Elaine Legg, to bill the Kentucky Medicaid Program for chiropractic services.
However, the evidence established that Almond never actually practiced at the Newport Chiropractic Center; the billed services were instead provided by other doctors, who had never been approved or enrolled in the Kentucky Medicaid Program.
Almond billed the Kentucky Medicaid Program using her National Provider Identification number, knowing that the program would not have paid for any claims for treatment rendered by unapproved providers.
The government proved that Almond and Legg fraudulently submitted approximately 1,943 claims to the Kentucky Medicaid Program, which totaled $483,797, and they received $95,098 in payments.
Almond’s co-conspirator, Elaine Legg, has already pled guilty in the case. In a separate case, Dr. Nanci Allen, a former part owner in the Erlanger Chiropractic Clinic, has pled guilty to a similar scheme to defraud the Kentucky Medicaid Program.
Andrea Almond is scheduled to appear for sentencing on September 4, 2014, and faces a maximum of 10 years in prison.
The investigation was conducted by the Federal Bureau of Investigation, the United States Postal Inspection Service, the Kentucky Attorney General’s Office, and the Kentucky Department for Medicaid Services.
Related Federal Cases
- Antwain Hamilton and Temeca Hamilton, Health Care Fraud, Ohio 2013 · Ohio
- Kenneth Jackson, Conspiracy to Commit Mail and Wire Fraud, Ohio 2023 · Texas
- Andrea M. Trgovcich, Securities and Bank Fraud, Ohio 2024 · Texas
- Tyjuan Eugene Crossty, Conspiracy to Distribute Controlled Substances, Kentucky 2023 · Indiana
- Extendicare Health Services Inc. and Progressive Step Corporation, Medicare Billing Fraud, Washington 2007 · Kentucky
Key Facts
- State: Kentucky
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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