Health Law Daily Conviction, 17 year sentence for fraud affirmed
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Wednesday, November 6, 2019

Conviction, 17 year sentence for fraud affirmed

By Anthony H. Nguyen, J.D.

Appellate court finds no reversible error in conviction of licensed occupational therapist for health care fraud.

The U.S. Court of Appeals for the Eleventh Circuit affirmed a district court’s sentence of 17 years and $8.3 million in restitution to a licensed occupational therapist for health care fraud. The therapist had signed patient evaluations without having seen patients herself. The therapist also entered into an agreement with a licensed physical therapist (PT) in which she, for additional payments, performed evaluations on the PT’s patients and provided the PT with the information necessary for the PT to complete fraudulent patient records. (U.S. v. Carreras, October 29, 2019, per curiam).

Appeal. A jury found the therapist guilty of health care fraud. The district court sentenced the therapist to 204 months’ imprisonment (17 years) and ordered her to pay restitution of over $8.3 million. On appeal, the therapist contended she was entitled to a new trial based on the district court’s failure to strike inadmissible hearsay evidence and to issue a curative instruction.

The appellate panel noted that even if it was assumed the district court erred in failing to strike hearsay evidence, a new trial was not warranted. The government presented overwhelming evidence of the therapist’s knowing participation in defrauding Medicare. Several co-conspirators testified about the therapist’s involvement in falsifying patient treatment records to facilitate billing Medicare for services that were either not rendered or that were performed by unlicensed therapists. The government also presented evidence of payments that the therapist received in exchange for her false signatures on patient records and provision of unlicensed therapy.

Moreover, the panel noted that the therapist perjured herself at trial. During testimony, the therapist denied having signed patient progress notes without having seen the patient, having treated or evaluated non-occupational-therapy patients, and having received compensation for seeing non-occupational-therapy patients. The therapist’s testimony was contradicted by the detailed testimony of several of her co-consiprators. The therapist was also unable to persuade the panel that her sentence was unreasonable.

The case is No. 18-12849.

Attorneys: Stephen Schlessinger, U.S. Attorney's Office, for the United States. Ronald Scott Lowy (Lowy and Cook P.A.) for Roxana Carreras.

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