A Texas medical consulting company owner has been sentenced to two years in federal prison for defrauding health insurers, announced U.S. Attorney for the Northern District of Texas Chad E. Meacham.
Steven Berglund, the 52-year-old owner of Elite Healthcare, pleaded guilty to conspiracy to commit wire fraud and healthcare fraud on November 10, 2021 – three days into his criminal trial. He later attempted to withdraw his plea, arguing that the stress of the trial had left him with diminished mental capacity. The court rejected his attempts, ruling that Mr. Berglund had understood his plea and entered it knowingly and voluntarily. He was sentenced Tuesday by U.S. Senior District Judge Terry Means.
At his trial, the government had introduced evidence showing that Mr. Berglund had organized and led an elaborate ‘pass-through billing’ scheme in which health insurers were deceived into paying Palo Pinto General Hospital for laboratory tests that were actually performed by out-of-network laboratories. The evidence also showed that Mr. Berglund and his coconspirators used an overseas company to conduct the fraudulent billing, and used front companies to pay kickbacks to induce doctors to order more laboratory tests.
According to court documents, Mr. Berglund and other members of the conspiracy submitted more than $54 million in laboratory services claims; as a result, insurers paid Palo Pinto more than $8 million. After paying the out-of-network labs, the billing company involved in the scheme, and kickbacks, the coconspirators divvied up the rest of the proceeds.
Mr. Berglund admitted to the scheme in plea papers. Four of his coconspirators were previously sentenced:
Aaron Cerpanya, co-owner of Elite, pleaded guilty to conspiracy to commit healthcare fraud and was sentenced to 12 months and one day in prison.
Adam Gardner, co-founder of MedHealth Solutions, also pleaded guilty to conspiracy to commit healthcare fraud and was sentenced to 12 months and one day in prison.
Cody Waddell, co-founder of MedHealth Solutions, pleaded guilty to conspiracy to commit healthcare fraud and was sentenced to 18 months in prison.
Harris Brooks, former CEO of Palo Pinto, pleaded guilty to conspiracy to commit healthcare fraud and was sentenced to five years’ probation.
The court ordered all five defendants jointly and severally liable for $2.4 million in restitution.
Related Federal Cases
- Jason Jarin, Medicaid Fraud and Illicit Transition Procedures, Texas 2023 · Oklahoma
- Mehmood Patel, Healthcare Fraud, Lafayette LA, 2023 · Texas
- Shannon Tecoko Mays, Conspiracy to Commit Wire Fraud, Texas, 2012 · Oklahoma
- James Pavlounis, Social Security Administration Fraud and Tax Evasion, California 2023 · Texas
- Juan A. Tony Marrero, Medicare Fraud Scheme, Miami FL, 2023 · Texas
Key Facts
- State: Texas
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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