Unlicensed Medical Assistant Convicted in $6 Million Fraud Conspiracy | OPA

Unlicensed Medical Assistant Convicted in $6 Million Fraud Conspiracy | OPA

A federal jury convicted an Illinois lady yesterday for conspiring to defraud Medicare of around $6 million.

According to court docket paperwork and evidence presented at trial, Rhonda Sutton, 58, of Matteson, worked as an unlicensed health-related assistant for a physician in Chicago and bordering regions from at the very least 2009 till at least 2012. In this position, Sutton conspired with some others, which include the house owners of two house wellness treatment businesses, to fraudulently certify Medicare beneficiaries for house health products and services for which these beneficiaries did not qualify.

Especially, Sutton forged her health practitioner employer’s signature on certification varieties and supporting documentation, which prompted Medicare beneficiaries to be enrolled in more than 2,000 episodes of residence wellness treatment at A&Z and Dominion property wellness businesses, equally found in Lansing, Illinois. Sutton delivered the forged medical professional varieties to A&Z and Dominion, which enabled A&Z and Dominion to post claims to Medicare for services that the beneficiaries did not have to have and were not capable to receive. The homeowners of A&Z and Dominion compensated Sutton kickbacks in trade for the forged medical doctor types. A&Z and Dominion obtained around $6 million from Medicare due to Sutton’s fraudulent perform.  

Sutton was convicted of conspiracy to commit well being care fraud. She is scheduled to be sentenced on March 16, 2023 and faces a optimum penalty of 10 several years in prison. A federal district courtroom decide will determine any sentence right after thinking about the U.S. Sentencing Recommendations and other statutory components.

Assistant Attorney Standard Kenneth A. Polite, Jr. of the Justice Department’s Felony Division U.S. Attorney John R. Lausch Jr. for the Northern District of Illinois Assistant Director Luis Quesada of the FBI’s Criminal Division Acting Special Agent in Demand John S. Morales of the FBI Chicago Discipline Place of work and Particular Agent in Charge Mario M. Pinto of the Department of Health and Human Services Business of Inspector Normal (HHS-OIG), Chicago Regional Business office produced the announcement.

The FBI and HHS-OIG investigated the scenario, which was brought as element of the Chicago Strike Drive, supervised by the Prison Division’s Fraud Section and the U.S. Attorney’s Office for the Northern District of Illinois.

Trial Lawyers Victor B. Yanz, Claire T. Sobczak, and Sarah W. Rocha of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Patrick Mott for the Northern District of Illinois prosecuted the circumstance.

The Fraud Part leads the Prison Division’s attempts to battle overall health treatment fraud by way of the Well being Treatment Fraud Strike Power System. Given that March 2007, this application, comprised of 15 strike forces operating in 24 federal districts, has charged additional than 4,200 defendants who collectively have billed the Medicare application for extra than $19 billion. In addition, the Facilities for Medicare & Medicaid Solutions, doing work in conjunction with the Place of work of the Inspector Basic for the Office of Overall health and Human Companies, are getting steps to keep vendors accountable for their involvement in health treatment fraud schemes. Far more information can be found at https://www.justice.gov/legal-fraud/overall health-treatment-fraud-device.