TiCo-owners of Pocatello Physical Therapy, P.A. Sentenced in Federal Courttle
POCATELLO – The co-owners of Pocatello Physical Therapy, P.A., were sentenced in U.S. District Court today for altering records in a federal health care audit, U.S. Attorney Wendy J. Olson announced. Dan DesFosses, 65, and Colin “Ric” Benedetti, 58, both of Pocatello, appeared before U.S. District Judge Edward J. Lodge at the federal courthouse. DesFosses and Benedetti were each sentenced to three years of probation. DesFosses was fined $1,000 and ordered to pay $9,757.66 in restitution. Benedetti was ordered to pay $2,442 in restitution. Both will be required to do 300 hours of community service.
On September 20, 2011, DesFosses pled guilty to a one count superseding information charging him with altering records in a federal investigation. According to court documents, the government agreed to dismiss the pending superseding indictment that charged 21 counts of executing a scheme to defraud health care benefit programs. DesFosses agreed to pay restitution to Medicare, Blue Cross of Idaho and a Nevada insurance company in connection with the dismissed health care fraud counts.
Benedetti pled guilty on September 19 to a one count information charging him with altering records in a federal investigation.
The charges arose out of changes made to patient records requested for audit by the Western Integrity Center (WIC), a program safeguard contractor for Medicare. According to court documents, in March 2006, Pocatello Physical Therapy Clinic, P.A. was asked to provide randomly selected documents to the WIC's Maryland location. At the time, DesFosses and Benedetti were business partners and licensed physical therapists in Idaho. According to court documents, DesFosses and Benedetti made additional entries to some of the patient files submitted for the March 2006 audit. A comparison of unaltered files showed that seven patient files were altered. The alterations, or additional entries, were consistent with amounts previously billed to Medicare.
The dismissed conduct involved billings to Medicare, Blue Cross of Idaho and Employers Insurance Company of Nevada for use of a cold laser, a noncovered service, under procedure codes for covered services that were not provided. The dismissed conduct also involved billings to Blue Cross of Idaho for services DesFosses provided to his wife. Blue Cross of Idaho does not pay for services a provider performs on a family member.
“Medicare relies on audits to ensure that federal health care dollars are properly spent,” said Olson. “Mr. DesFosses and Mr. Benedetti's alteration of records submitted for audit undermines the integrity of the audit process. Their felony convictions should serve as a stern reminder to other providers that such misconduct in the Medicare audit process will not be tolerated.”
“The Medicare program relies on the honesty of those treating our patient population,” stated Ivan Negroni, Special Agent in Charge, United States Department of Health and Human Services Office of the Inspector General. “We will partner with the Medicare Program Safeguard Contractors and others to investigate health care fraud in the District of Idaho. The altering of medical records in order to justify false billings to the Medicare program will be investigated and violators will be prosecuted.”
The case was investigated by Health and Human Services, Office of Inspector General.
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