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Press Release

Louisiana Man Enters Guilty Plea for Health Care Fraud

For Immediate Release
U.S. Attorney's Office, Southern District of West Virginia

Defendant fraudulently obtained over $150,000

CHARLESTON, W.Va. – Edward Stephen entered a guilty plea for federal health care fraud, announced United States Attorney Mike Stuart.  Stephen, 61, of Baton Rouge, Louisiana, faces up to 10 years of incarceration, a $250,000 fine, and three years of supervised release when he is scheduled to be sentenced on October 28, 2020.  He also will be subject to an order of restitution for $151,660.53, with the final determination to be made by the court at sentencing.

“For 12 years Mr. Stephen lied to get federal health insurance for ineligible family members,” United States Attorney Mike Stuart said. “Let this be a clear message, if you are cheating the system we will find you.”

Stephen was a federal employee with the United States Department of Transportation Federal Highway Administration. As a federal employee, he was eligible for health insurance provided by the federal government. Stephen fraudulently enrolled extended family members into his federal  health care plan knowing they were not eligible for federal health care benefits. Specifically, Stephen enrolled his sister as though she was his wife and his niece as though she was his stepchild so that they would obtain federal health care coverage they were not entitled to receive. This scheme lasted from 2005 to 2017 and included several years where Stephen resided in and worked in Charleston, West Virginia as a federal employee. When investigators learned of the fraud, Stephen gave a statement to investigators with Department of Transportation Office of Inspector General, in which he admitted that he fraudulently placed his extended family members on his federal insurance knowing they were not entitled to receive benefits. In total, the health insurance company was defrauded out of $151,660.53 in fraudulent premium payments and reimbursements.

Stuart praised the work of the Department of Transportation Office of Inspector General and the Office of Personnel Management Office of Inspector General. The investigation was conducted by members of the United States Attorney’s Healthcare Fraud Abuse, Recovery and Response Team (ARREST), an approach linking civil and criminal enforcement efforts together in a comprehensive attack on the opioid epidemic and healthcare fraud. United States Attorney Mike Stuart announced the formation of ARREST in February 2019. All health care related cases in the Southern District of West Virginia, whether they are the subject of criminal or civil investigation or enforcement, are directed through ARREST. Included within the purview of the team are the Opioid Fraud and Abuse Detection Unit, Affirmative Civil Enforcement Unit, Appalachian Regional Prescription Opioid (ARPO) Strike Force, Medicare and Medicaid fraud, and asset forfeiture efforts related to all health care matters.

United States District Judge Irene C. Berger presided over the plea hearing. Assistant United States Attorney Erik S. Goes handled the prosecution.


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Updated June 10, 2020

Health Care Fraud