Nurse Practitioner Sentenced for Filing False Claims with Health Insurance Companies and Identity Theft
ATLANTA—Daphne Maria Patterson has been sentenced to five years and one month in federal prison for health care fraud and aggravated identity theft for filing claims with health insurance companies in which she sought reimbursement for providing medical care to patients that she never provided. Patterson stole personal identifying information from her patients and their family members so she could file more than $2 million in claims from five health insurance companies.
“This defendant was a trusted health care official who stole personal information from her patients’ and their families to enrich herself,” said U.S. Attorney John Horn. “Patterson thought nothing of defrauding health insurance companies or the effects that her scheme could have on her patients’ lives.”
“The defendant in this case displayed a complete disregard for those patients that she victimized as well as the insurance companies that she stole from. The FBI will continue to work with its various law enforcement partners to better protect health care insurance providers and their clients from this type of fraud,” said J. Britt Johnson, Special Agent in Charge, FBI Atlanta Field Office.
“Fraudulent actions like Ms. Patterson’s not only betrayed the trust that patients placed in her, but they also made everyone’s insurance premiums go up,” Commissioner Hudgens said. “I’m appreciative that U.S. Attorney Horn’s office diligently pursued prosecution in this case.”
According to U.S. Attorney Horn, the charges and other information presented in court: Patterson’s fraud began when she worked as a nurse practitioner for a general medical practice in Lawrenceville, Georgia. Although she was not supposed to bill insurance companies as an employee, she stole identifying information of her patients, and their family members—most of whom Patterson had not treated at all. She filed false claims with the insurer claiming to have provided various allergy tests and treatments to the beneficiaries, when in fact she had not provided these services.
Once her employment with the general medical practice ended, Patterson opened her own clinic, called Healthier U 4 Ever Complete Wellness Center in Stone Mountain, Georgia. While there, Patterson used her patients’ personal information to continue her scheme, and billed various health insurance companies for expensive allergy tests and treatments, when in fact most patients were receiving weight loss advice and assistance. In total, Patterson received more than $1 million from the health insurance companies as a result of her false claims.
Daphne Maria Patterson, 44, of Lithonia, Georgia, has been sentenced to five years, one month in prison to be followed by three years of supervised release, and ordered to pay restitution in the amount of $1,153,383.76. Patterson was convicted of these charges on October 7, 2015, after she pleaded guilty.
This case was investigated by the Federal Bureau of Investigation and the State of Georgia Office of Commission of Insurance.
Assistant United States Attorney Jamie L. Mickelson prosecuted the case.