Headlines that Matter for Companies and Executives in Regulated Industries

Telemedicine Owner Pleads Guilty to $136 Million Medicare Fraud

A licensed nurse practitioner in New Jersey, Jean Wilson, pleaded guilty to conspiracy to commit health care fraud and wire fraud. According to court documents, Wilson owned two purported telemedicine companies, Advantage Choice Care (ACC) and Tele Medcare LLC, as well as two orthotic brace suppliers, Southeastern DME and Choice Care Medical. Wilson recruited and bribed medical professionals to sign prescriptions for Medicare beneficiaries for orthotic braces or prescription drugs that were medically unnecessary, ineligible for Medicare reimbursement, or misrepresented.

A number of medical professionals recruited by Wilson signed orthotic brace orders without interacting with Medicare beneficiaries or after only a brief telephonic communication. As a result, approximately $136 million worth of fraudulent claims for orthotic braces and prescription drugs were submitted to Medicare, Medicare sponsors, and Medicare Part D plans. Of this $136 million, at least $66 million was paid by Medicare, Medicare sponsors, and Medicare Part D plans. As part of Wilson’s plea deal, she agreed to pay $66 million in restitution to Medicare and the Internal Revenue Service (IRS).

Wilson is scheduled to be sentenced on July 18 and faces a maximum of 20 years in prison.

Read the US Department of Justice’s (DOJ) press release here.

Ford to Pay $365 Million for Alleged Misclassification of Vehicles

Ford Motor Company reached a $365 million settlement with the United States to resolve allegations that, from April 2009 to March 2013, Ford misclassified and understated the value of hundreds of thousands of its cargo vans in violation of the Tariff Act of 1930. The government alleged that Ford imported Transit Connect cargo vans from Turkey to the United States with sham rear seats and other features to make the vans appear to be passenger vehicles.

Vans classified as passenger vehicles have a duty rate of 2.5%, while vans classified as cargo vehicles have a duty rate of 25%. Ford allegedly submitted paperwork classifying its vehicles as “motor cars and other motor vehicles principally designed for the transport of persons” in order to pay a 2.5% duty rate. The government alleged that after US Customs and Border Protection (CBP) cleared the vehicles, Ford removed the rear seats in the vans to return the vans to their original two-seat cargo van state. Ford is also alleged to have misclassified the value of the vehicles to CBP to avoid paying import duties.

Read the DOJ's press release here.

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