Last week, the DOJ announced that Jean Wilson, the owner of two telemedicine companies and two orthotic braces suppliers, had pleaded guilty to  conspiracy to commit health care fraud and wire fraud for her role in a $136 million Medicare fraud scheme.

According to court documents, Wilson owned Advantage Choice Care LLC (ACC), Tele Medcare LLC (Tele Medcare), Southeastern DME, and Choice Care Medical. Wilson used her telemedicine and durable medical equipment (DME) companies to recruit and bribe medical professionals to sign medically unnecessary prescriptions for medicine and DME. The medical professionals signed fraudulent prescriptions that were ineligible for reimbursement or not provided as represented. Wilson’s recruited medical professionals often signed orders for orthotic braces without any interaction with Medicare beneficiaries or after only a brief telephone call. Nonetheless, Wilson and the providers falsified documents to support their Medicare claims.

According to the DOJ, Wilson caused the submission of approximately $136 million in fraudulent claims for orthotic braces and prescription drugs to be submitted to Medicare, Medicare sponsors, and Medicare Part D Plans. Wilson received at least $66 million from the foregoing. Wilson is scheduled to be sentenced on July 18, 2024 and now faces a maximum of 20 years in prison. Wilson will also pay $66 million in restitution to Medicare and the IRS.

The attorneys at Chilivis Grubman represent clients of all types and sizes in connection to health care fraud investigations and litigation, including investigations related to DME. If you need assistance with such a matter, please contact us today.