A NY health care provider is sentenced to 12 years in prison for $10 million Medicare fraud and HIPAA identity theft

15 April 2013

Defendant Stole Patient Records From Nursing Homes To Create And Submit False Medicare Claims

Earlier today, Helene Michel, an owner and officer of Medical Solutions Management, Inc. (“MSM”), was sentenced to 12 years in federal prison by United States District Judge Joseph F. Bianco at the federal courthouse in Central Islip, New York. Michel was convicted after a three-week jury trial in August 2012 of conspiracy to commit health care fraud, health care fraud, and HIPAA identity theft crimes. At today’s sentencing, Judge Bianco also ordered that Michel forfeit $1.3 million that was seized by the government at the time of her indictment.

The sentences were announced by Loretta E. Lynch, United States Attorney for the Eastern District of New York, Thomas O’Donnell, Special Agent in Charge, United States Department of Health & Human services, Office of Inspector General, Office of Investigations (“HHS OIG”), and George C. Venizelos, Assistant Director in Charge, Federal Bureau of Investigation (“FBI”), New York Field Office.

According to the evidence at trial, between approximately April 2003 and March 2007, Helene Michel owned and operated MSM, a medical equipment company located in Hicksville, New York. Michel used her position as a medical equipment company owner to enter nursing homes in Nassau, Suffolk, Queens, Kings, and Dutchess Counties in order to access and steal patient records, in violation of the Health Insurance Portability and Accountability Act (“HIPAA”). During the scheme, Michel also falsely assumed a number of roles, including posing at various times as a doctor, a nurse practitioner, and a wound care expert. At times, in her false roles, Michel even accompanied doctors on patient evaluation rounds. Thereafter, Michel used the records that she stole to create and submit $10 million in false billings to Medicare for medical supplies and products that were either not required or not delivered. For example, in one instance, Michel used fraudulent drawings and measurements to support a Medicare claim for the cost of fitted boots for a legless patient. In another, Michel submitted false claims for the purchase of expensive wound care bandages to treat patients who never had such wounds. In the event that Medicare denied an MSM claim, Michel submitted an appeal of the denial supported by additional stolen and altered patient records.

Michel spent the Medicare funds that she stole through false claims and identity theft on her own personal interests, including a multi-million dollar home on Long Island’s North Shore, a half-million dollar pension account, and personal items such as luxury cars and designer handbags. Michel’s co-defendant Etienne Allonce, the co-owner of MSM, was also charged in the indictment and is believed to have fled from the United States. He remains a fugitive, listed on HHS OIG’s Most Wanted List.

“Helene Michel brazenly roamed the halls of dozens of nursing homes, pretending to be, among other things, a doctor, a nurse practitioner, and a wound care expert, even going so far as to join patient evaluations. In reality she was a con woman, deceiving patients and administrators alike as she trolled for the information she used to submit fraudulent claims to Medicare to support her extravagant lifestyle. Through her scheme she violated the privacy of over a thousand patients and stole Medicare funds dedicated to preserving the health of our seniors and other citizens,” stated United States Attorney Lynch. “We and our law enforcement partners will vigorously pursue and prosecute those who seek to profit by such despicable crimes.” Ms. Lynch expressed her grateful appreciation to HHS OIG, the FBI, and the Nassau County District Attorney’s Office.

The government’s case was prosecuted by Assistant United States Attorneys Charles P. Kelly and Burton T. Ryan, Jr.

Article sourced from:http://www.justice.gov/usao/nye/pr/2013/2013apr10.htmlhttp://www.justice.gov/usao/nye/pr/2013/2013apr10.html