HELENA, Montana – In a shocking case of health care fraud, Elizabeth Jones Powell, 52, of East Helena, Montana, was sentenced to five years imprisonment and three years supervised release for her role in a scheme that bilked Medicaid and the Internal Revenue Service out of hundreds of thousands of dollars.
According to court documents, federal prosecutors alleged that Powell, along with her husband’s physical therapy practice, submitted false claims to Medicaid for services that were never provided. The scheme, which spanned from 2009 to 2012, resulted in a loss of $290,476 to Medicaid, as well as an additional $25,664 and $18,343 in losses to 63 other medical providers and Medicaid’s pharmacy program, respectively.
The scheme was uncovered by the Montana Surveillance and Utilization Review Section (SURS), which noticed irregularities in the practice’s billing to Medicaid in 2012. After requesting documents to support the claims, SURS received inadequate responses and conducted further investigation, which revealed that Powell had created patient files shortly after the request was made, and that the family members for whom the practice billed Medicaid had not actually received the services they were billed for.
As part of her scheme, Powell also filed false tax returns, substantially understating her income from the physical therapy practice. According to her accountant, Powell provided him with figures stating the amount of income she received from the practice, which he then listed on her return to the IRS. However, after Powell’s fraud came to light, the accountant issued amended Forms 1099 listing the additional income, which Powell did not file an amended return reflecting.
Powell was ordered to pay $420,891.08 to four insurers and $43,514 to the Internal Revenue Service as part of her sentence.
The U.S. Attorney’s Office conducted a separate review of Gordon’s bank account and computed the monies Powell diverted from the bank account for her own benefit. The analysis also revealed insurance checks Powell diverted from the practice and deposited into bank accounts Gordon had no control over.
Powell is scheduled to begin serving her sentence on [sentence date].
Mandatory Facts: Elizabeth Jones Powell, 52, of East Helena, Montana, was sentenced to five years imprisonment and three years supervised release for her role in a scheme to defraud Medicaid and the Internal Revenue Service. Powell was ordered to pay $420,891.08 to four insurers and $43,514 to the Internal Revenue Service. The scheme, which spanned from 2009 to 2012, resulted in a loss of $290,476 to Medicaid, as well as an additional $25,664 and $18,343 in losses to 63 other medical providers and Medicaid’s pharmacy program, respectively.
Key Facts
- State: Montana
- Category: White Collar Crime|Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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