November 10, 2011
PALISADE MAN PLEADS GUILTY TO DEFRAUDING HEALTH CARE PROGRAMS FOR NUCLEAR WEAPONS WORKERS AND MINERS
DENVER – Anthony Paul Breaux, of Palisade, Colorado, pled guilty this morning to health care fraud and money laundering greater than $10,000 in connection with his actions to defraud government funded health care programs meant to compensate nuclear weapons workers and certain miners. The guilty plea was tendered before U.S. District Court Judge Christine M. Arguello. Judge Arguello is scheduled to sentence Breaux on March 16, 2012 at 10:00 a.m.
Breaux was indicted by a federal grand jury on September 1, 2011. He pled guilty today, November 10, 2011.
According to public court documents, including the indictment and the stipulated facts contained in the plea agreement, in October 2009, Breaux created and was acting as a registered agent for Honor-Bound Healthcare Providers (HBHP), a Colorado Corporation. Breaux owned 100 percent of Honor-Bound, and was in the business of providing home health care services to patients in Colorado, Oregon, Arizona and elsewhere.
Part of Honor-Bound’s patients were nuclear weapons workers or miners, millers and transporters. In order to be reimbursed for providing medical services to these individuals, Breaux billed Energy Employees Occupational Illness Compensation Program (EEOICP) and pursuant to the Radiation Exposure Compensation Act (RECA). EEOICP is a health care benefit program that provides lump-sum compensation and health benefits to eligible Department of Energy nuclear weapons workers. RECA provides coverage to eligible uranium miners, millers, and transporters. Coverage is extended under both acts to certain eligible survivors with lump-sum compensation that would have otherwise been payable to the workers. The United States Department of Labor (DOL), Office of Workers’ Compensation Programs, Division of Energy Employees Occupational Illness Compensation (DEEOIC) is responsible for administering EEOICP.
From June 2010 until June 2011, Breaux, doing business through Honor-Bound, knowingly and willfully executed and attempted to execute a scheme to defraud these health care benefit programs, by submitting and causing to be submitted bills for payment, knowing those bills already had been paid. In other cases the defendant submitted invoices for services never provided. He obtained payments on the claims in part by submitting false supporting documentation. In total, the fraud the defendant perpetrated is over $3.5 million.
Breaux recruited individuals to provide care to the DEEOIC claimants he recruited who lived on the Indian Reservation in Arizona, and these individuals were family members who were already taking care of the beneficiaries. Breaux told the family members HBHP could pay them $13 per hour for care they were providing. The individuals who provided the care to the claimants in Arizona were not Registered Nurses, but Breaux billed DEEOIC at the Registered Nurse rate, $90 to $100 per hour, for the care the family members provided. Breaux knew this was not right, but he did it because of the large amount of money he was able to bring into HBHP. Breaux also forged doctor signatures he submitted to DEEOIC so that DEEOIC would authorize 24 hour, 7 day a week home health care.
On or about December 4, 2010, Breaux knowingly engaged in a monetary transaction of criminally derived property of a value of $18,235.47 by writing, delivering and causing the depositing and cashing of a check by a person Breaux used to recruit patients eligible as claimants; those funds had been derived from unlawful activity. The parties stipulated that the aggregate loss to the victims in this case was in excess of $3,400,000.
Breaux faces not more than 20 years in federal prison and a fine of up to $250,000 for health care fraud. He also faces not more than 10 years in federal prison and a fine of up to $250,000 or alternatively a fine not more than twice the amount of the criminal derived property, or both, money laundering greater than $10,000.
This case was investigated by the Department of Labor Office of the Inspector General (DOL OIG), the Internal Revenue Service – Criminal Investigation (IRS-CI) and the Federal Bureau of Investigation (FBI).
The defendant is being prosecuted by Assistant U.S. Attorneys Jaime Pena and Tonya Andrews.