Newport Chiropractor Convicted of Health Care Fraud Conspiracy
|U.S. Attorney’s Office May 05, 2014|
COVINGTON, KY—The owner of a chiropractic clinic in Newport, Kentucky, has been convicted of a fraud scheme involving tens of thousands of dollars.
A federal jury in Covington convicted 48-year-old Andrea Almond, of Cincinnati, Ohio, of conspiracy to commit health care fraud, late Friday afternoon. The jury returned the verdict after four days of trial, following six hours of deliberation.
According to evidence established at trial, from September 2008 through April 2010, Almond conspired with a co-defendant to bill the Kentucky Medicaid Program for chiropractic services rendered at the Newport Chiropractic Center.
The evidence, however, also established that Almond never actually practiced at the Newport Chiropractic Center; the billed services were instead provided by other doctors, who had never been approved or enrolled in Kentucky Medicaid Program.
Almond billed the Kentucky Medicaid Program using her National Provider Identification number, knowing that the Kentucky Medicaid Program would not have paid for any claims for treatment rendered by unapproved providers.
The government proved that Almond and her co-conspirator fraudulently submitted approximately 1,943 claims to the Kentucky Medicaid Program, which totaled $483,797, and they received $95,098 in payments.
Her co-conspirator, Elaine Legg, has already pled guilty in the case. In a separate case, Dr. Nanci Allen, a former part owner in the Erlanger Chiropractic Clinic, has pled guilty to a similar scheme to defraud the Kentucky Medicaid Program. These individuals are also awaiting sentencing.
Kerry B. Harvey, United States Attorney for the Eastern District of Kentucky; Perrye Turner, Special Agent in Charge, Federal Bureau of Investigation; Dugan Wong, Postal Inspector in Charge, United States Postal Inspection Service, Pittsburg Field Division; and Jack Conway, Kentucky Attorney General, jointly made the announcement today.
The investigation was conducted by the Federal Bureau of Investigation; the United States Postal Inspection Service, Cincinnati Field Office; the Kentucky Attorney General’s Office, Medicaid Fraud Abuse and Control Unit; and the Kentucky Department for Medicaid Services. The federal government was represented by Assistant United States Attorney Laura K. Voorhees.
Almond will appear for sentencing on September 4, 2014. She faces a maximum of 10 years in prison. However, any sentence following a conviction will be imposed after the court considers the U.S. Sentencing Guidelines and the applicable federal statutes.