Lecanto Medical Biller Sentenced In Large Healthcare Fraud Scheme
Tampa, FL – U.S. District Judge Mary S. Scriven today sentenced Teresa Johnson (53, Lecanto) to five years’ probation, with four months of home detention, for conspiring with a local doctor to commit health care fraud. As part of her sentence, the court also ordered Johnson to pay restitution to the defrauded federal health care programs and, entered a money judgment of more than $5,700, representing a portion of Johnson’s health care fraud proceeds.
Johnson had pleaded guilty on October 10, 2019.
According to court documents, Johnson owned and operated a medical billing company, Tri-County Billing, which submitted mostly false and fraudulent claims for three clinics owned and operated by Doctor 1 (recently deceased). The clinics were located in Crystal River, Spring Hill, and Celebration. Most of the false claims from Doctor 1’s clinics were submitted to government healthcare programs including Medicare, Medicaid, TRICARE, and CHAMPVA. Johnson had previously worked for Doctor 1 in several different capacities before Doctor 1 financially assisted her in opening Tri-County Billing. Doctor 1 filed bankruptcy on behalf of his medical practice in April 2019.
As part of the scheme, Doctor 1 employed numerous health care providers, many who were not authorized to perform, and prohibited from, billing for medical services. Doctor 1 directed Johnson to bill claims performed by these prohibited health care providers as if they were rendered by Doctor 1, when they were not. One of these providers was a pain management doctor who had been denied enrollment in the Medicare and Medicaid program. Another doctor had been excluded from billing, directly or indirectly, any government healthcare programs. Doctor 1 also hired nurse practitioners to perform medical services, and directed Tri-County to submitted claims as if a doctor had performed those services. Both Johnson and Doctor 1 knew all of these claims were false and fraudulent.
This case was investigated by the Federal Bureau of Investigation, the U.S. Department of Health and Human Services, Office of Inspector General, the Department of Defense, Office of Inspector General, the Department of Veterans Affairs, Office of Inspector General, and the Florida Office of Attorney General’s Medicaid Fraud Control Unit. It was prosecuted by Assistant U.S. Attorney Kelley Howard-Allen.