States Attorney's Office District of Connecticut
|May 10, 2010||
WALLINGFORD WOMAN ADMITS MAKING FALSE CLAIMS TO MEDICARE AND MEDICAID
David B. Fein, United States Attorney for the District of Connecticut, today announced that STACEY LEE WILLIAMS, 38, of Wallingford, pleaded guilty on Friday, May 7, before Senior United States District Judge Ellen Bree Burns in New Haven to one count of submitting false claims to Medicare and Medicaid.
According to court documents and statements made in court, on February 1, 2007, while a resident of Arizona, WILLIAMS pleaded guilty to one felony count of forgery and was later sentenced to two years probation and 30 hours of community service. On October 22, 2007, when applying for a renewal of her LPN license in the state of Connecticut, WILLIAMS checked “no” when asked if she had been convicted in the last year of a felony. Based in part on this false representation, WILLIAMS’ Connecticut license was renewed.
On June 3, 2008, WILLIAMS began working at Soundview Healthcare and Rehabilitation, a skilled nursing facility in West Haven that accepts payment from Medicare and Medicaid. On her employment application, she used a false social security number and again claimed that she had no felony convictions.
On December 18, 2008, WILLIAMS applied to Jewish Home for the Elderly, a skilled nursing facility in Fairfield that receives funding from Medicare and Medicaid. In her application, she again falsely claimed to have no felony convictions. WILLIAMS was hired as a full-time employee on February 9, 2009, and she worked there for approximately five months. During her employment, WILLIAMS never disclosed that she had been excluded by the Department of Health and Human Services, which caused the facility to submit claims to Medicare and Medicaid that were not allowable.
Judge Burns has scheduled sentencing for July 26, 2010, at which time WILLIAMS faces a maximum term of imprisonment of five years and a fine of up to $250,000.
U.S. Attorney Fein also today announced that Jewish Home for the Elderly of Fairfield County Inc. has entered into a civil settlement agreement with the Government in which it has agreed to pay $28,542 to resolve allegations that it violated the False Claims Act by submitting claims to Medicare and Medicaid for services provided by WILLIAMS.
U.S. Attorney Fein explained that when the United States Department of Health and Human Services, Office of the Inspector General (HHS-OIG) excludes an individual or entity from federal health care programs, no program payments may be made for items or services furnished by that excluded individual or entity. In September 1999, HHS-OIG issued a Special Advisory Bulletin in order to provide guidance to health care providers who might employ or contract with an excluded individual or entity. The Special Advisory Bulletin advised that in order to avoid potential liability, health care providers should check the List of Excluded Individuals/Entities on the HHS-OIG web site. In September 2005, the Connecticut Department of Social Services issued a similar bulletin, warning providers of their responsibility to perform appropriate due diligence to ensure that payments were not being made for services provided by an excluded individual or entity.
Jewish Home for the Elderly failed to check the HHS-OIG online exclusion database before hiring WILLIAMS.
To resolve their liability under the False Claims Act, Jewish Home for the Elderly of Fairfield County Inc. has agreed to pay damages on the portion of WILLIAMS’ salary attributable to federal health care programs. The False Claims Act provides for treble damages and penalties of $5,500 to $11,000 per false claim submitted to the Government. However, if the person or entity who violates the act promptly discloses the violation to the Government and fully cooperates with any Government investigation of the violation, the Government can recover only up to double damages.
Jewish Home for the Elderly of Fairfield County Inc. also agreed to enter into a certification promising it has established policies and procedures to check both prospective and current employees to make sure that they have not been excluded from federal healthcare programs.
In entering into the civil settlement agreement, Jewish Home for the Elderly of Fairfield County Inc. did not admit liability.
This matter has been investigated by the Department of Health and Human Services, Office of Inspector General and the Federal Bureau of Investigation. The criminal case is being prosecuted by Assistant United States Attorney Paul H. McConnell, and the False Claims Act civil settlement was prosecuted by Assistant United States Attorney Anne F. Thidemann, along with Auditor Kevin A. Saunders.
People who suspect health care fraud are encouraged to report it by calling the Health Care Fraud Task Force at (203) 785-9270 or 1-800-HHS-TIPS.
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