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Capital Blue Cross Employee Indicted in $292,000 Health Care Scam
Harrisburg – A former employee of Capital Blue Cross and four others have been charged with health care fraud conspiracy, according to federal officials.
The indictment, handed down by a federal grand jury in Harrisburg, alleges that Chireta E. Dantzler, a 34-year-old former health claims examiner with Capital Blue Cross, was the mastermind behind a scheme to file fake health insurance claims on behalf of Victoria Thomas, 37, Henry Nolen Bell, 61, Latanya Deidre Hill, 45, and Deneen Maria Whiteside, 56.
According to the government, the scheme took place in 2012 and 2013 and resulted in approximately $292,000 in fraudulent claims being paid to the conspirators. The intended loss was approximately $400,000.
The government alleges that the conspirators provided Dantzler with their personal identifying information and that she would file bogus health insurance claims on their behalf, representing that each of the defendants received health care ambulance services when, in fact, they had not.
Capital Blue Cross staff discovered the scheme and cooperated in the fraud investigation, as did the other providers involved, including CareFirst and Excellus Health Plan.
Dantzler, who was dismissed by Capital Blue Cross in 2014, is also charged alone with three separate counts of Health Care Fraud in connection with claims submitted in 2013.
The investigation was conducted by the Harrisburg Office of the Federal Bureau of Investigation. The case is assigned to Assistant United States Attorney Joseph J. Terz.
Indictments are only allegations. All persons charged are presumed to be innocent unless and until found guilty in court. A sentence following a finding of guilt is imposed by the Judge after consideration of the applicable federal sentencing statutes and the Federal Sentencing Guidelines.
The maximum penalty under federal law is 10 years of imprisonment, a term of supervised release following imprisonment, and a fine of $250,000.
The case highlights the importance of vigilance in preventing health care fraud and the need for cooperation between health care providers and law enforcement agencies.
Key Facts
- State: Pennsylvania
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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