Telemedicine Nurse Practitioner Pleads Guilty to $7.8 Million Durable Medical Equipment Fraud Scheme
Psychiatrist Convicted of Billing Medicare and Private Insurance Companies for Services Never Rendered
BOSTON – A Virginia-based nurse practitioner has been charged in connection with a $7.8 million telemedicine fraud scheme involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces.
Daphne Jenkins, 64, was charged with one count of conspiracy to commit health care fraud.
According to the charging documents, between December 2018 and April 2020, Jenkins worked with a telemedicine company to sign orders for medically unnecessary durable medical equipment. It is alleged that these orders signed by Jenkins were pre-populated based on telemarketing calls made to Medicare beneficiaries, that Jenkins never had any contact with the beneficiaries herself and had no medical relationship with the patients, and that she generally signed these orders without even reading them. It is alleged that once Jenkins signed these orders, the telemarketing company sold the orders to DME suppliers and laboratories, which then submitted claims to Medicare. As a result of Jenkins’ alleged participation in this conspiracy, over $7.8 million in claims were submitted to Medicare for DME that was medically unnecessary, based on false documentation, and tainted by kickbacks.
The charge of conspiracy to commit health care fraud provides for a sentence of up to 10 years in prison, up to three years of supervised release and a fine of up to $250,000 or twice the gross pecuniary gain or loss, whichever is greater. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and statutes which govern the determination of a sentence in a criminal case.
Acting United States Attorney Joshua S. Levy; Roberto Coviello, Special Agent in Charge, Health and Human Services-Office of Inspector General; Jodi Cohen, Special Agent in Charge, Federal Bureau of Investigations, Boston Division; Ketty Larco-Ward, Inspector in Charge, United States Postal Inspection Service, Boston Division; Carol S. Hamilton, Regional Director, Employee Benefits Security Administration, U.S. Department of Labor; and Patrick Hegarty, Special Agent in Charge, Defense Criminal Investigation Service, North East Field Office made the announcement today. Assistant U.S. Attorneys Lauren Graber and Howard Locker of the Health Care Fraud Unit and Alexandra Brazier and Lindsey Ross of the Affirmative Civil Enforcement Units are prosecuting the case.
The details contained in the charging documents are allegations. The defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.