Health Care Scam Exposed: $5.9 Million Stolen in Dallas
Two clinic workers in the Dallas area have been charged with conspiracy to commit health care fraud, involving a massive $5.9 million scheme to defraud the Department of Labor.
Melissa Sumerour, 47, of Waco, Texas, and Latosha Morgan, 41, of Dallas, Texas, have been indicted on one count of conspiracy to commit health care fraud.
The indictment alleges that from January 2011 to March 2017, Sumerour and Morgan, along with their co-conspirators, engaged in an ‘upcoding’ scheme to bill the Department of Labor for more expensive services than those actually performed, if any. This resulted in the defrauding of the Department of Labor of approximately $5.9 million through fraudulent worker’s compensation claims.
The indictment also alleges that Sumerour and Morgan worked at clinics in Temple and Fort Worth, Texas, respectively, which treated almost exclusively Department of Labor patients. They allegedly routinely billed for higher reimbursable services in order to earn bonuses based on the percentage that their clinics billed.
The charges in the indictment are merely allegations, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
The investigation was led by the Office of the Inspector General, U.S. Postal Service Office of Inspector General, and the U.S. Department of Labor Office of Inspector General. Assistant Chief Adrienne Frazior of the Criminal Division’s Fraud Section is prosecuting the case.
Key Facts
- State: Texas
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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