Alton Woman Pleads Guilty To Health Care Fraud

Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, announced today that on September 11, 2013, Roslyn James, 46, of Alton, IL, pled guilty to a one-count indictment charging that she engaged in a scheme to commit health care fraud. At her sentencing James will face up to 10 years in prison, a fine of up to $250,000, and up to 3 years of supervised release. Sentencing has been set for January 10, 2014, at 11:00 a.m. in United States District Court in East St. Louis, Illinois.

During her plea hearing, James admitted that she had submitted false and fraudulent bills in relation to the providing of personal assistant services in the Home Services Program, a Medicaid Waiver Program designed to allow individuals to stay in their homes instead entering a nursing home. James admitted that she falsely billed the program for over $50,000 for services that were supposed to have been provided to her son. In reality, the person who James claimed as having provided the services lived in the State of California.

The investigation was conducted by the U.S. Department of Health and Human Services, Office of Inspector General; Illinois State Police; and the St. Clair County Sheriff’s Department. The case is being prosecuted by Assistant United States Attorneys Ranley R. Killian and William E. Coonan.

If you suspect or know of an individual or company that is not complying with healthcare laws or public aid programs, you may report this activity to the local office of the U.S. Department of Health and Human Services, Office of Inspector General or call 1-800-447-8477.