GRIMY TIMES EXCLUSIVE
A Texas woman, Melissa Sumerour, was sentenced to 18 months in prison for her role in a massive $5.5 million worker’s compensation overbilling scheme. The scheme, which was uncovered by a joint investigation between multiple agencies, involved Sumerour overbilling the U.S. Department of Labor’s Office of Workers’ Compensation Program for physical therapy and other services.
According to evidence presented during Sumerour’s trial in December 2019, the scheme ran from approximately January 2011 to March 2017. During this time, Sumerour billed the Office of Workers’ Compensation Program for physical therapy services that were not provided, resulting in over $5.5 million in fraudulent payments.
Sumerour, 49, of Lorena, Texas, was convicted of six counts of health care fraud in December 2019. She was sentenced by U.S. District Judge Karen Gren Scholer of the Northern District of Texas to 18 months in prison followed by three years of supervised release.
This case is a prime example of the ongoing problem of healthcare fraud in the United States. The U.S. Department of Labor’s Office of Workers’ Compensation Program is just one of many programs that are vulnerable to these types of scams.
The investigation into Sumerour’s scheme was led by the U.S. Department of Justice – Office of the Inspector General, the U.S. Department of Labor – Office of Inspector General, the U.S. Postal Service – Office of Inspector General, the U.S. Department of Veterans Affairs – Office of Inspector General, and the U.S. Army Criminal Investigation Command’s Major Procurement Fraud Unit.
Latoshia Morgan, another defendant in the case, has pleaded guilty and is awaiting sentencing.
The Fraud Section, which is responsible for prosecuting healthcare fraud cases, has a long history of success in bringing these types of cases to justice. Since its inception, the Fraud Section has charged over 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion.
We will continue to follow this case and bring you updates as more information becomes available.
Key Facts
- State: Texas
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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