A Houston-area patient recruiter has pleaded guilty to participating in a $5.2 million Medicare fraud scheme, announced the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section.
Sammie Wilson, 69, pleaded guilty on July 18, 2011, in connection with the $5.2 million Medicare fraud scheme. According to court documents, Family Healthcare Group, a Houston-based home health care company, purported to provide skilled nursing to Medicare beneficiaries.
The owner of Family Healthcare Group hired Wilson and other co-conspirators to recruit Medicare beneficiaries for the purposes of filing false claims with Medicare. Family Group used the Medicare beneficiary numbers to submit claims to Medicare for skilled nursing that was medically unnecessary and/or not provided.
Wilson was paid kickbacks for referring beneficiaries for services that she knew were not medically necessary and/or not rendered. Furthermore, Wilson herself is a Medicare beneficiary, and Family Group billed Medicare for providing her services that were not medically necessary and/or not provided.
At sentencing, scheduled for July 18, 2011, Wilson faces a maximum sentence of 10 years in prison.
The case is being prosecuted by Trial Attorneys Charles D. Reed and Sam S. Sheldon of the Criminal Division’s Fraud Section. The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section.
Since their inception in March 2007, Medicare Fraud Strike Force operations in seven districts have obtained indictments of more than 825 individuals who collectively have falsely billed the Medicare program for more than $2 billion.
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Key Facts
- State: Federal
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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