Louisiana Resident Sentenced to 18 Months in Prison for Role in Medicare Fraud Scheme
WASHINGTON – A patient recruiter for several Louisiana durable medical equipment (DME) companies was sentenced today to serve 18 months in prison for her role in a Medicare fraud scheme involving fraudulent claims and illegal kickback payments for unnecessary DME, announced the Department of Justice, the Department of Health and Human Services (HHS), the FBI and the Louisiana State Attorney General's Office.
Karen T. Rayburn, 47, was sentenced today by U.S. District Judge James J. Brady of the Middle District of Louisiana. In addition to her prison term, Rayburn was sentenced to two years of supervised release and ordered to pay $3.18 million in restitution.
Rayburn pleaded guilty on Jan. 19, 2012, to one count of conspiracy to commit health care fraud.
According to court documents, Rayburn worked as a recruiter for Healthcare 1 LLC, Medical 1 Patient Services LLC and Lifeline Healthcare Services Inc., Louisiana-based companies that fraudulently billed medical equipment to the Medicare program from 2004 to 2009. She and other recruiters were hired to obtain prescriptions for medical equipment such as leg braces, arm braces, power wheel chairs and wheel chair accessories. Rayburn obtained information from Medicare beneficiaries as well as falsified prescriptions for medical equipment. These prescriptions were then used to submit fraudulent claims to the Medicare program.
According to court documents, from 2004 to 2009, the companies involved in these schemes submitted more than $21 million in fraudulent claims to Medicare, and as a result of the prescriptions that Rayburn collected the companies submitted more than $6 million in fraudulent claims.
Eight other defendants have been sentenced for their roles in this scheme, and three additional defendants await sentencing.
Today’s sentence was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Donald J. Cazayoux Jr. of the Middle District of Louisiana; Mike Fields, Special Agent-in-Charge of Dallas Region for the HHS Office of the Inspector General (HHS-OIG); Michael Anderson, Special Agent-in-Charge of the FBI's New Orleans Division; and James Buddy Caldwell, Louisiana State Attorney General.
The case was prosecuted by Assistant Chiefs Ben Curtis and William Pericak and Trial Attorneys David Maria and Abigail Taylor of the Criminal Division's Fraud Section. The case was investigated by the FBI, HHS-OIG, and the Medicaid Fraud Control Unit of the Louisiana State Attorney General’s Office (MFCU), and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Middle District of Louisiana.
Since its inception in March 2007, the Medicare Fraud Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have billed the Medicare program for more than $4 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.