Michigan Vascular Surgeon Sentenced to 80 Months in Prison for Health Care Fraud Conviction and Agrees to Pay Up to $43.419 Million to Resolve False Claims Act Allegations
A grand jury indictment was unsealed today charging Patrick Wittbrodt, Dr. April Tyler and Jeffrey Fillmore of Genesee County with health care fraud and Patrick Wittbrodt with money laundering, United States Attorney Matthew Schneider announced.
Schneider was joined in the announcement by William P. Conway, Special Agent in Charge, FDA Office of Criminal Investigations’ Chicago Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office.
The Indictment charges the defendants with a conspiracy to commit health care fraud and 17 counts of health care fraud. The Indictment specifically charges that between 2014 and 2017, the defendants would attend meetings of the United Auto Workers (“UAW”) union. At those meetings, the defendants touted unnecessary prescription pain cream, scar cream, pain patches and vitamins to UAW members. The prescriptions were unnecessary because Dr. April Tyler did not establish a valid doctor-patient relationship with any of the UAW members and/or did not determine medical necessity for the prescriptions she wrote for the UAW members. Many of the compounded pain and scar creams were billed to the insurance company at over $15,000 per prescription.
Over the course of the conspiracy, the defendants caused fraudulent claims to be submitted to Blue Cross/Blue Shield of Michigan and/or Express Scripts totaling approximately $9,500,000. Over the same period, Medicare paid over $800,000 in fraudulent prescription claims.
Defendant Patrick Wittbrodt is also charged with seven counts of money laundering in connection with the illegal proceeds of the health care fraud conspiracy.
“Health care fraud involving medically necessary prescriptions not only is dangerous to those patients receiving the drugs, but also drives up the cost of health care for everyone,” stated United States Attorney Matthew Schneider. “This indictment demonstrates that our office is committed to stamping out health care fraud in the Eastern District of Michigan.”
“When medical professionals and others scheme to illegally provide unneeded drugs to consumers, they violate the public trust,” said William P. Conway, Special Agent in Charge, FDA Office of Criminal Investigations’ Chicago Field Office. “Our office will continue to pursue and bring to justice those who are criminally involved in the distribution of medicines.”
“Writing medically unnecessary prescriptions for health care items and products and thus causing them to be billed to federal and private health insurance programs is wrong and illegal” said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services, Office of Inspector General. “Fraudulent acts such as this threaten vitally important programs such as Medicare and the beneficiaries they serve. The OIG will continue to work with our law enforcement and prosecutorial partners to ensure that individuals that perpetuate these types of fraudulent schemes are held accountable.”
Health care fraud, conspiracy to commit health care fraud and money laundering are each punishable by up to 10 years imprisonment and/or a $250,000 fine on each count.
This case is being prosecuted by Assistant United States Attorney Michael Heesters and Health Care Fraud Chief Wayne F. Pratt.
The case was investigated by the U.S. Department of Health and Human Services, Office of Inspector General and the U.S. Food and Drug Administration.
An indictment is only a charge and is not evidence of guilt. Each defendant is entitled to a fair trial in which it will be the government’s burden to prove guilt beyond a reasonable doubt.