The Justice Department has announced that the owner of the Florida-based medical billing company, Regency, has pleaded guilty to conspiracy to commit health care fraud and filing a false tax return.
Kelly Wolfe agreed to settle criminal charges and civil claims arising out of false claims to the US for braces and other medical equipment that amount to over $20m.
In turn, the Indian Rocks Beach now faces a maximum penalty of 13 years in federal prison, with her company also agreeing to a civil resolution.
Brian Boynton, acting assistant attorney general at the Department of Justice’s civil division, said: “The department is committed to ensuring that federal health care program providers do not place their own financial gain over patients’ clinical needs.
“When medical professionals and companies knowingly commit fraud to maximize their profits, we will hold them accountable for their unlawful conduct.”
According to documents seen in court, Wolfe used Regency to establish dozens of medical equipment (DME) supply companies through “trickery and deception”.
Wolfe was then able to gain control of these companies, submitting over $400m in illegal DME claims to Medicare and the Civilian Health and Medical Program.
Maria Chapa Lopez, a US attorney for the Middle District of Florida, said: “Fraud and deceit in our nation’s health care system is not only unacceptable, it is illegal.
“The US Attorney’s Office will continue to aggressively work with our investigative partners in rooting out these illicit practices to ensure that patients receive the optimum care they deserve.”