The U.S. Attorney’s Office places a high priority on criminal and civil enforcement in cases involving health care fraud and unauthorized health care benefits payments, as well as related activities such as fraud against the elderly and prescription drug fraud. The office works on these matters with the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), the Federal Bureau of Investigation, the Internal Revenue Service, the Drug Enforcement Administration, the Food and Drug Administration (FDA), the Office of the Pennsylvania Attorney General, District Attorney’s Offices within the Middle District, the Pennsylvania Department of State and the NEPA Insurance Fraud Task Force.
Anyone with information concerning suspected health care fraud or irregularities should contact the HHS-OIG at 1-800-HHS-TIPS (1-800-447-8477) and/or the U.S. Attorney’s Office at 717-221-4482, attention Assistant U.S. Attorneys Kim Douglas Daniel (Criminal) or D. Brian Simpson (Civil), Health Care Fraud Coordinators.
Criminal Cases - Health Care Fraud
Belinda Dietrich, a 63-year-old Marysville, Cumberland County woman was sentenced on October 28, 2019, to one year and a day of imprisonment for forging the signature of a dentist on 164 prescriptions for opioid drugs. Dietrich, a former receptionist for a solo dental practitioner forged the signature of her employer on a blank prescription form for oxycodone pills for her mother, a Medicare beneficiary, who was not a patient of the dentist. Dietrich then had the prescription filled at a Harrisburg area pharmacy and received 24 oxycodone pills, who then converted the drugs to her own use. The pharmacy billed the cost of the oxycodone pills to Medicare, which paid the claim.
Mohamed Abdelhamed, a 68-year-old York man was sentenced on June 27, 2019, to two years’ probation on Health Care Fraud charges. Abdelhamed applied for Medicaid and SNAP benefits with the York County Assistance Office even though he owned a four bedroom residence in York, a gas station in York, a 2008 Mercedes Benz E350 automobile, received $1,124 a month in Social Security disability benefits, and held approximately $58,500 in eight different bank accounts. Abdelhamed sold his gas station for $172,883 and deposited $87,016 of the sales proceeds into a bank account and he did not notify the York County Assistance Office of the sale or his receipt of the sales proceeds and continued to receive Medicaid and SNAP benefits and fraudulently obtained approximately $29,337 in benefits, including approximately $20,000 in Medicaid
Michael Timothy Buchanan
Michael Timothy Buchanan, age 68, of Indiana, pleaded guilty on May 14, 2019, to defrauding a trust fund established by the Association of Pennsylvania State College and University Faculties (APSCUF) out of $1,493,629. Buchanan executed a scheme to defraud the Pennsylvania Faculty Health and Welfare Fund (The Fund) between 2007 and 2017 by his submission of false, inflated invoices for the services his company, Actuaries, Consultants and Administrators, Inc. (ACA), provided The Fund in connection with the processing of dental and vision claims submitted by members of the APSCUF Union. Buchanan was sentenced to 37 months's imprisonment on February 26, 2020 and ordered to pay $1,493,629 in restutition to the Fund.
On June 5, 2018, Dr. Fuhai Li, a 53-year-old physician licensed by the Commonwealth of Pennsylvania and authorized to prescribe Schedule II controlled substances, was found guilty by a federal jury of unlawfully prescribing oxycodone and other opioids to 23 former patients, including a Honesdale woman who died as a result of using the pills and a pregnant woman who gave birth to an opioid-dependent baby.
Li owned and operated the Neurology and Pain Management Center in Milford, Pike County, Pennsylvania. Between August 2011 and January 2015, Dr. Li wrote 26,985 prescriptions for Schedule II controlled substances, 99.37% of which were written for opioids. This included 18,115 prescriptions for oxycodone, of which 12,129 were written for oxycodone 30 milligrams, the highest dosage available in short acting oxycodone. Other opioids frequently prescribed by Dr. Li included methadone, OxyContin, hydrocodone and hydromorphone. Li repeatedly falsified patient medical records and made material omissions in those records in an effort to legitimize the unlawful prescriptions.
Former patients testified that they became addicted to opioids as a result of Li’s prescriptions. One patient testified she had sex with Li on almost every visit to his office during a four-year period and several former patients testified that they earned money by selling drugs prescribed to them by Li and used part of that money to buy heroin to support their addiction.
The jury also convicted Li of using two medical offices for the purpose of unlawfully prescribing opioids. Li was also convicted of tax evasion for the tax years 2011, 2012, and 2013 for underreporting his taxable income for those years by more than $800,000.
The jury’s verdict also included the forfeiture to the United States of $1,030,960 in cash that was seized from Li’s two residences; $1,036,079.36 seized from various bank accounts; real property located at 200 3rd Street, Milford (Li’s medical office); and real property located at 4005 Milford Landing Drive, Milford.
On April 3, 2019, Li was sentenced to 330 months' imprisonment.
Dr. Raymond Kraynak, age 60, of Mt. Carmel, Pennsylvania, was indicted by a federal grand jury on December 20, 2017. The 19-count indictment alleges that Kraynak, who operated two offices in Mt. Carmel and Shamokin, Pennsylvania, known as Keystone Family Medicine Associates, prescribed approximately 2.7 million units of oxycodone, hydrocodone, oxycontin and fentanyl to approximately 2,838 patients between January 2016 through July 31, 2017. During that time period, he was the top prescriber of those drugs in the Commonwealth of Pennsylvania. It’s also alleged that Dr. Kraynak caused the death of five of his patients between 2013 and 2015 by unlawfully distributing and dispensing controlled substances to them that ultimately led to their death. Trial is tentatively scheduled for May 4, 2020.
Joan Cicchiello, age 67, of Annville and Mount Carmel, Pennsylvania, was sentenced on May 9, 2018, to 72 months’ imprisonment and three years of supervised release on Health Care Fraud related charges. Cicchiello, a licensed Certified Registered Nurse Practitioner and Registered Nurse who is certified by the Commonwealth of Pennsylvania, was the owner and operator of Twilight Beginnings, located in Mount Carmel, that provided mental health services. Cicchiello used her company to recruit individuals who were either not properly licensed or unlicensed and have them “provide” psychiatric care to patients. Despite the fact that Cicchiello knew these individuals were not trained, licensed nor authorized to provide these psychiatric related services, Cicchiello directed that they meet with elderly residents of nursing homes throughout central and northeastern Pennsylvania, as well as with adolescents seeking psychiatric care at her Mount Carmel, Pennsylvania office. These individuals, whom Cicchiello referred to as her “counselors,” included a retired chiropractor, a convicted felon whose clinical social worker license was suspended, and numerous other unqualified individuals. Cicchiello directed these individuals provide to her with a listing of the patients they met. Cicchiello then utilized these lists to falsely bill the Medicare program as though she, a properly licensed and trained practitioner, personally provided face-to-face psychotherapy related services to the adolescent and elderly patients.
Pauline M. Wolfe, et al.
On June 26, 2018, a federal grand jury returned four indictments charging ten residents of Cumberland and Perry County with obtaining possession of oxycodone, a Schedule II Controlled Substance, by misrepresentation, fraud and forgery. The indictments alleged that between December 2016, and June 2017, the defendants conspired with each other and others to create false, fraudulent and forged prescriptions for oxycodone. Several of the defendants were also charged with making false statements in connection with payment of health care benefits. The indictment also alleges several defendants used the Medicare and Medicaid program benefits to pay for the forged prescriptions they filled at area pharmacies. At least three of the defendants stole the identities of Medicare and Medicaid beneficiaries to obtain payment for the fraudulently obtained opioids. The conspiracy is alleged to have resulted in the unlawful possession of approximately 10,000 oxycodone tablets. All defendants pleaded guilty and were sentenced as follows:
- Pauline M. Wolfe, age 62, of Carlisle, PA - sentenced to two years' probation on March 14, 2019;
- Bruce A. Greenwald, age 40, Mechanicsburg, PA - sentenced to two years' probation on March 14, 2019;
- Angela L. Greenwald, age 40, Mechanicsburg, PA - sentenced to two years' probation on March 21, 2019;
- Charles J. Greenwald, age 31, of Carlisle, PA - sentenced to three months' imprisonment on October 16, 2019;
- Heather Amanda Wolfe, age 27, of Carlisle, PA - sentenced to two years' probation on July 15, 2019;
- Megan Nico Bergstresser, age 31, Carlisle, PA - sentenced to two years' probation on November 1, 2019;
- Amy Beth Jones, age 32, Mechanicsburg, PA - sentenced to two years' probation on March 20, 2019;
- Joseph Benjamin Shatto, age 28, of Carlisle, PA - sentenced to two years' probation on June 3, 2019;
- Melissa L. Hunsicker, age 43, of Enola, PA - sentenced to two years' probation on April 30, 2019; and
- David Allen Hunsicker, age 48, of Dillsburg, PA - sentenced to one year probation on August 23, 2019.
Dr. Robert L. Stremmel, age 74, of York, Pennsylvania, was indicted on June 27, 2018, by a federal grand jury with dispensing opiates and amphetamines outside the course of a professional practice and not for a legitimate medical purpose. The indictment alleges that Stremmel was licensed to practice medicine in the Commonwealth of Pennsylvania and had a medical office in York. It is alleged that between July 2013 and January 2018, Stremmel distributed to one person more than 21,000 tablets of oxycodone and dextroamphetamine-amphetamine, both Schedule II controlled substances. The indictment also charges Stremmel with prescribing Xanax, codeine, and Tramadol, Schedule IV and V controlled substances. It is alleged that Stremmel intentionally prescribed these controlled substances outside the usual course of professional practice and not for a legitimate medical purpose. The indictment further charged Stremmel with making a false statement related to a health care matter for allegedly falsifying medical records in conjunction with a Medicare claim. Stremmel pleaded guilty on October 1, 2018, and was sentenced on October 9, 2019 to two years probation.
Dr. Charles Gartland
While conducting an internal audit, WellSpan Health determined that its employee, Dr. Charles Gartland was writing Schedule II prescriptions in the name of his wife and daughter. WellSpan disclosed its findings to the DEA. The investigation determined that Gartland was writing the prescriptions for his personal use and neither his wife nor daughter were aware of his scheme. While there was no identifiable loss to a federal insurance program, Gartland’s conduct violated the Controlled Substance Act. Following an ability to pay analysis, the USAO settled with Gartland for $15,000 in April 2019.
Dr. Robert Ettlinger
On December 7, 2018, Dr. Robert Ettlinger, a primary care doctor formerly practicing in Millersburg, Pennsylvania, agreed to pay $45,000 to settle allegations that he violated the federal Controlled Substances Act by prescribing schedule II opioid controlled substance medications, which were issued for no legitimate medical purpose. Dr. Ettlinger wrote 185 opioid prescriptions to six of his patients between 2013 and 2015, which were issued with no legitimate medical purpose and outside the usual course of his professional practice, resulting in civil violations of the Controlled Substances Act. Dr. Ettlinger cooperated with the DEA’s investigation. As part of the settlement, Dr. Ettlinger entered into a Memorandum of Agreement with the DEA under which he agreed to comply with heightened compliance requirements for prescribing controlled substances.