Monday, April 25, 2011

Matthew Paul Brown Indicted for Health Care Fraud and Other Criminal Violations


ATLANTA—MATTHEW PAUL BROWN, 29, of Nashville, Tennessee, has been indicted and made an initial appearance this afternoon before United States Magistrate Alan Baverman on charges of health care fraud and wrongful disclosure of individually identifiable health information.

United States Attorney Sally Quillian Yates said, “The Medicare and Medicaid systems are designed to provide elderly and needy individuals with necessary medical care by duly trained and licensed medical personnel. This defendant’s alleged impersonation of a doctor defrauded those systems, private health insurance companies, and the patients he treated, who were unaware of his lack of qualifications. In the coming weeks, federal investigators will be contacting the patients this defendant treated in the Atlanta area regarding this case.”

Brian D. Lamkin, Special Agent in Charge, FBI Atlanta, said, “The fraudulent activities alleged in the federal indictment of Mr. Brown are considered extensive and serious in that, over an extended period of time, this defendant is alleged to have diverted federal monies from those that truly needed them. The FBI will continue to investigate this matter in an effort to determine the further extent of these alleged activities by Mr. Brown.”

According to United States Attorney Yates and the charges: From November 2009 through April 5, 2011, BROWN carried out a health care fraud scheme in the metro Atlanta and Nashville, Tennessee areas. While operating in the Atlanta area, from November 2009 through August 2010, BROWN allegedly approached numerous practicing physicians and persuaded them to bill Medicare, Medicaid, and private health insurers under their own provider numbers for allergy-related care provided by BROWN. The indictment alleges that the care was provided both at the physicians’ own offices and at health fairs, with the physicians agreeing to pay BROWN between 50 percent and 85 percent of a total of approximately $1.2 million they received from the health care benefit programs.

According to the indictment, BROWN has never been licensed in Georgia as a physician, physician assistant, nurse practitioner, or clinical nurse specialist.

BROWN is also charged with wrongful disclosure of individually identifiable health information, in violation of the Health Insurance Portability and Accountability Act (“HIPAA.”) Specifically, the indictment charges that on March 20, 2011, BROWN knowingly disclosed individually identifiable health information to another person, under false pretenses and with the intent to use the information for commercial advantage and personal gain.

The indictment charges 17 counts of health care fraud, each of which carries a maximum sentence of 10 years in prison and a fine of up to $250,000. The HIPAA charge also carries a maximum sentence of 10 years in prison and a fine of up to $250,000. In determining the actual sentence, the court will consider the United States Sentencing Guidelines, which are not binding, but provide appropriate sentencing ranges for most offenders.

Members of the public are reminded that the indictment contains only allegations. A defendant is presumed innocent of the charges and it will be the government’s burden to prove a defendant’s guilt beyond a reasonable doubt at trial.

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