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Health care fraud and prison time: Texas woman heads to jail

The government recently accused a Texas woman of partaking in a health care fraud scheme that took place in Arkansas. The woman allegedly used her role recruiting patients for a company that marketed prescription medications for a Mississippi pharmacy.

The prosecution stated the woman recruited patients to receive expensive medications they did not need. In some cases, the government states the group would offer gift cards and other incentives to get patients to sign on for treatment. The organization would then bill Tricare, allegedly earning over $10 million in less than one year. The woman herself allegedly received $300,000 in illegal kickbacks for her role in the scheme.

After facing the allegations, the woman pled guilty to charges of Anti-Kickback Statute (AKS) violations. A U.S. District Court Judge sentenced her earlier this week.

Judge deviates from recommended sentencing guidelines

A violation of the AKS can result in up to 5 years imprisonment and a fine of $250,000. In this case, the federal sentencing guidelines for the crime recommend a 24 to 30-month prison sentence. The judge determines the federal sentencing guideline numbers by imputing several factors, including the sum of money involved in the scheme. The judge ultimately agreed with the defense attorney that a more lenient sentence was warranted. He sentenced the woman to 14-months imprisonment.

The judge stated he made his decision based on the amount of money involved and a consideration of everyone’s culpability in the scheme. He also notes that unlike other crimes, white collar crimes like health care fraud generally do not come with parole. The government charged seven people in connection with this scheme and thus far has sentenced individuals to prison for 8 to 28 months.