Former VA Psychologist Charged With Submitting False Medical Documents to Employer, Obstruction of Justice, Medicare Fraud
EAST ST. LOUIS, Ill. – Yesterday afternoon, a federal grand jury in East St. Louis
returned an indictment charging a former owner and two top tier executives of a south
Florida telemarketing business known as Simple Health with federal fraud offense. Former owner
Steven Dorfman, 37, of Fort Lauderdale, FL, former Chief Compliance Officer, Candida L. Girouard,
45, of Valrico, FL, and former Vice President of Sales John A. Sand, 47, of Fort Lauderdale, FL,
were all charged with one count of conspiracy to commit mail and wire fraud, four counts of mail
fraud, and eight counts of wire fraud.
Simple Health, also known as Health Benefits One, sold health insurance policies over the phone.
The vast majority of the policies sold by Simple Health were limited indemnity plans.
Limited indemnity plans have a relatively low cap on the amount of medical expenses they will
cover. After those caps are reached, the patients are responsible for paying 100% of their
medical expenses out of their own pockets.
The indictment alleges that Simple Health employed a deceptive sales script to trick
people into purchasing the limited indemnity plans. Among other things, the script required the
Simple Health salespersons to tell the customers that: “The whole idea of this plan is to make
your out of pocket expenses as low as possible . . . .” and “When all is said and done, you end up
with pennies on the dollar!!” Relying on these and other false and misleading representations, thousands of people across the country purchased limited indemnity plans from Simple Health. According to the
indictment, after customers purchased these policies, they frequently called Simple Health’s
Customer Service Department and complained that (1) they had incurred significant medical expenses
that they had been led to believe would be covered, but were not; (2) their doctors and hospitals
did not accept the limited indemnity plans; and (3) their prescription drug costs were not covered,
contrary to what they were told when the purchased the policies.
In October 2018, the Federal Trade Commission’s Midwest Regional Office in Chicago took action to
prevent Simple Health from defrauding any additional consumers. The complaint filed by the FTC
requested that the federal court in south Florida enter an injunction prohibiting Simple Health
from violating federal consumer protection laws. In addition, at the request of the FTC, the
court appointed a receiver take over operations of the business. The litigation in that case is ongoing.
“We credit the Federal Trade Commission for their continued vigilance to protect the community from
predatory and unscrupulous businesses operating online,” said United States Attorney
Steven D. Weinhoeft. “Crimes like those alleged in the indictment rob people of their hard-earned
money, but worse, they have catastrophic consequences when expected insurance benefits aren’t there
in a time of need. These offenses ruin lives and must be dealt with harshly.”
The indictment charges that from May 4, 2012, through November 1, 2018, Simple Health
sold policies to over 400,000 people nationwide, generating revenues to Simple Health of
more than $190,000,000. Simple Health sold 1,175 policies to individuals residing in all 38
counties that comprise the Southern District of Illinois.
Dorfman, Girouard, and Sand are scheduled to appear in federal court in East St. Louis on Monday,
March 7, 2022, for their arraignments. Because the alleged scheme was conducted via telemarketing
and victimized ten or more persons over the age of 55, the maximum penalty for the conspiracy count
is 30 years, pursuant to the SCAMS Act. Each of the mail and wire fraud counts carries a maximum
sentence of up to 20 years in prison. In addition, the defendants can be ordered to pay full
restitution to the victims.
U.S. Attorney Steven D. Weinhoeft of the Southern District of Illinois made the announcement. The
St. Louis Office of the U.S. Postal Inspection Service is investigating the case.
Assistant U.S. Attorneys Scott Verseman and Peter Reed are prosecuting the case.