Pass-Through Palo Pinto: Healthcare CEO Sentenced to Two Years for $54 Million Fraud

A medical consulting company owner has been sentenced to two years in federal prison for a $54 million pass-through billing scheme that defrauded health insurers.

Steven Berglund, the owner of Elite Medical Consulting, pleaded guilty in Nov. 2021 to conspiracy to commit wire fraud and healthcare fraud three days into his trial. He tried to withdraw his plea and say that the stress of the trial had impacted his mental capacity, but the court denied his attempt.

The fraud deceived health insurers into paying Palo Pinto General Hospital for laboratory tests that out-of-network laboratories performed. Palo Pinto’s rural status meant it received higher reimbursements than urban hospitals or out-of-network labs.

Source: Pass-Through Palo Pinto: Healthcare CEO Sentenced to Two Years for $54 Million Fraud / D Magazine

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