A licensed nurse practitioner in New Jersey, Jean Wilson, pleaded guilty to conspiracy to commit health care fraud and wire fraud. According to court documents, Wilson owned two purported telemedicine companies, Advantage Choice Care (ACC) and Tele Medcare LLC, as well as two orthotic brace suppliers, Southeastern DME and Choice Care Medical. Wilson recruited and bribed medical professionals to sign prescriptions for Medicare beneficiaries for orthotic braces or prescription drugs that were medically unnecessary, ineligible for Medicare reimbursement, or misrepresented.
A number of medical professionals recruited by Wilson signed orthotic brace orders without interacting with Medicare beneficiaries or after only a brief telephonic communication. As a result, approximately $136 million worth of fraudulent claims for orthotic braces and prescription drugs were submitted to Medicare, Medicare sponsors, and Medicare Part D plans. Of this $136 million, at least $66 million was paid by Medicare, Medicare sponsors, and Medicare Part D plans. As part of Wilson’s plea deal, she agreed to pay $66 million in restitution to Medicare and the Internal Revenue Service (IRS).
Wilson is scheduled to be sentenced on July 18 and faces a maximum of 20 years in prison.
Source: Telemedicine Owner Pleads Guilty to $136 Million Medicare Fraud / The National Law Review