Vanessa Dowell, Medicare Fraud Scheme, Michigan 2007

A Detroit-area occupational therapy assistant has pleaded guilty to participating in a Medicare fraud scheme, announced the FBI and HHS.

Vanessa Dowell, 50, pleaded guilty yesterday before U.S. District Court Judge Avern Cohn in the Eastern District of Michigan to one count of conspiracy to commit health care fraud. At sentencing, Dowell faces a maximum penalty of 10 years in prison and a $250,000 fine.

According to the plea documents, Dowell was an uncertified occupational therapy assistant who worked for Jos Campau Physical Therapy, which purported to provide physical and occupational therapy services. In 2005, Dowell was hired by a co-defendant to create and sign falsified occupational therapy files for Jos Campau Physical Therapy, which was owned and operated by two co-defendants. Dowell purported to be a certified occupational therapy assistant and fabricated and signed patient notes for occupational therapy services that she claimed she had provided. In fact, the services were never provided. Furthermore, as an unsupervised and uncertified assistant, Dowell was not permitted to perform the occupational therapy services.

Between approximately June 2005 and May 2007, Dowell and her co-conspirators at Jos Campau submitted or caused the submission of fraudulent physical therapy and occupational therapy claims to the Medicare program. Dowell personally submitted or caused to be submitted approximately $807,760 in claims for occupational therapy services that were never provided.

This case is being prosecuted by Trial Attorney Catherine K. Dick of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since their inception in March 2007, the strike force operations in nine districts have charged more than 1,140 individuals who collectively have falsely billed the Medicare program for more than $2.9 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

Vanessa Dowell’s guilty plea is a significant step towards holding accountable those who perpetrate Medicare fraud schemes. As the case moves forward, it will be interesting to see the outcome and how it will impact the healthcare industry.

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