Court Employee Pleads Guilty to $185,000 Scheme to Cheat Health Insurance Program
KANSAS CITY, Mo. – Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that an employee of the Kansas City, Mo., Municipal Court pleaded guilty in federal court today to stealing more than $185,000 from the city’s health insurance provider, along with hundreds of other public employees, by falsely claiming to have run marathons and competed in other athletic events for cash incentives.
Crystal Burgin-Woods, 43, an employee of the municipal court, pleaded guilty before U.S. District Judge Gary A. Fenner to one count of wire fraud.
By pleading guilty today, Burgin-Woods admitted that she made fraudulent submissions to the city’s health insurance program on behalf of 383 employees, resulting in the issuance of 939 gift cards worth a total of $185,665.
Burgin-Woods received health insurance coverage from Blue Cross/Blue Shield of Kansas City. She was therefore eligible to participate in a wellness program called “Points to Blue.” The program offered gift cards to Burgin-Woods and other insured employees based upon entries made to the Points to Blue Web site, where they could log various exercise programs and diet programs. Every 1,000 “points” earned by an employee translated to $1 towards a gift card, up to a maximum of $250 annually. More strenuous exercises earned more points.
Burgin-Woods and other employees submitted materially false entries to the Points to Blue Web site, purporting to have completed extremely strenuous activities in order to fraudulently obtain the maximum gift card of $250. To make even more money in this scheme, Burgin-Woods and others submitted materially false entries for other employees and their eligible dependents, in exchange for receiving a portion of the fraudulent gift card proceeds.
Among the fraudulent submissions that Burgin-Woods made to Points to Blue were claims that a 3-year-old child had completed four triathlons, three marathons, two duathlons and three half marathons.
Burgin-Woods is among six employees of the city of Kansas City, Mo., who have pleaded guilty to their roles in the wire fraud scheme.
Matt Tholen, 30, an emergency medical technician, admitted that he made fraudulent Points to Blue submissions on behalf of 62 employees, resulting in 144 gift cards worth a total of $17,600. Tholen was sentenced on Sept. 5, 2013, to three years of probation and ordered to pay $17,600 in restitution.
Matt Stivers, 42, an employee of the city’s information technologies department, admitted that he made fraudulent Points to Blue submissions on behalf of 80 employees, resulting in 248 gift cards worth a total of $39,070.
Kim Blair, 36, an employee of the city’s parks and recreation department, admitted that she made fraudulent Points to Blue submissions on behalf of 83 employees, resulting in 238 gift cards worth a total of $30,485.
Sylvia Sims, 47, an employee of the city’s parks and recreation department, admitted that she made fraudulent Points to Blue submissions on behalf of 28 employees, resulting in 90 gift cards worth a total of $8,925.
Michael King, 31, an employee of the city’s water department, admitted that he made fraudulent Points to Blue submissions on behalf of 51 employees, resulting in 79 gift cards worth a total of $12,745.
As a result of the scheme, 1,253 fraudulent gift cards were issued, totaling $310,960.
Under federal statutes, each of the defendants is subject to a sentence of up to 20 years in federal prison without parole, plus a fine up to $250,000. A sentencing hearing will be scheduled after the completion of a presentence investigation by the United States Probation Office.
This case is being prosecuted by Assistant U.S. Attorney John E. Cowles. It was investigated by the U.S. Postal Inspection Service Task Force, U.S. Immigration and Customs Enforcement's (ICE) Homeland Security Investigations (HSI) and the Overland Park, Kan., Police Department.