The U.S. Attorneys Office is encouraging people to report if they believe they have been the victims of Medicaid or Medicare fraud.
The warning comes in the wake of a federal sentencing today in Wilmington after a Nash County woman pled guilty in a scheme to defraud healthcare benefit programs by submitting false and fraudulent claims. These were claims to Medicare requesting reimbursement for durable medical equipment that exceeded the actual cost of the equipment delivered.
United States Attorney Thomas G. Walker announced in a press release that Donna Dickens, 55 was sentenced by Senior United States District Court Judge James C. Fox to 60 months imprisonment and three years supervised release.
She was ordered to pay $1,729,390 in restitution and a $100 special assessment.
On December 6, 2011 she pled guilty to health care fraud.
According to the criminal information filed on September 2, 2011, from approximately January, 2005, to the end of March, 2010 Dickens was doing business as Dickens Health Care Supplies where she executed a scheme to defraud health care benefit programs.
According to the information presented in court, representatives of DHC would go to patient’s homes and ask the Medicare beneficiaries about their medical conditions, obtain the names of the beneficiaries’ physicians, and their Medicare numbers.
An order or prescription form would then be completed. The original would be sent to the primary physician for the physician to sign.
Often times the physicians would deny the request, but sometimes the physicians would mark through the items not needed and sign for other items that they felt were needed. However, DHC would still bill Medicare for equipment that was denied by the physicians.
Moreover, DHC would bill Medicare for more expensive equipment than was delivered to the Medicare beneficiaries. It is estimated that DHC caused Medicare to pay approximately $1,000,000 in fraudulent payments to DHC for equipment that was not necessary, not needed, or not delivered.
Investigation of this case was conducted by the United States Department of Health and Human Services. Assistant United States Attorney Felice McConnell Corpening prosecuted the case for the government.
If you suspect Medicare or Medicaid fraud please report it by phone at 1-800-447-8477 email
