6% gets you 4: Medical biller sentenced to four years for taking cut of physician's fraud

by Julia Kyles, CPC on Jul 10, 2017

A billing company's client became a co-conspirator in fraud and now a biller will spend four years in prison.

The Department of Justice announced June 30 that Dawn Bentley, the owner of White Lake, Mich.-based Physician's Medical Billing Service, had been sentenced for her role in a $7 million scheme to defraud Medicare and Medicaid.

According to the evidence presented at trial, from June 2014 through June 2015, Bentley knowingly submitted fraudulent bills on behalf of a co-conspirator physician for services she knew could not have been rendered, and for services she knew had not been rendered as billed. In exchange, Bentley was paid 6% of the total billings paid to the physician from Medicare, the evidence showed. Bentley’s largest client was Waseem Alam, who pleaded guilty to a $33 million Medicare fraud scheme in March 2016. Bentley billed $1.9 million of this fraud from June 2014 to June 2015, and was paid 6% of Alam’s receipts for the fraudulent billings, the evidence showed. Bentley’s company received over $100,000 from Alam’s practices between June 2014 and June 2015, the evidence showed.

Bentley will serve 50 months in prison and one year of supervised release. In addition she was also ordered "to pay $3,253,107 in restitution jointly and severally with her co-defendants."

The original indictment contains the details of Bentley's role in the fraud, which was part of a much larger scheme that involved bribes and drugs.

Blog Tags: anti-fraud, compliance
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