Tuesday, December 20, 2011

B. Elise Miller Charged with Health Care Fraud in Violation of Title 18

Source-  http://www.fbi.gov/cleveland/press-releases/2011/coshocton-woman-charged-with-health-care-fraud 

A federal grand jury in Cleveland, Ohio, returned an indictment charging B. Elise Miller, age 57 of Coshocton, Ohio, with 14 counts of health care fraud in violation of Title 18, United States Code, Section 1347, said Steven M. Dettelbach, United States Attorney for the Northern District of Ohio.

Miller is currently facing charges from two earlier indictments charging her, her husband Dana Campbell, Douglas Bolden, and James Ireland, with obstruction of justice and conspiracy.

The indictment alleges that from about 1987 to November 2008, Miller owned and operated Three Rivers Infusion and Pharmacy Specialists (Three Rivers), a medical infusion and pharmacy supply company located in Coshocton, Ohio.

In 2008, Three Rivers was under investigation by federal and state agencies for suspected over-billing of medical insurance companies for services and drugs, including a drug called Synagis used to treat infants to help prevent influenza. In August 2008, the government searched Three Rivers and seized various files including some files of patients who received Synagis, according to court documents.

The current indictment charges that Miller caused Three Rivers to file false and fraudulent claims for reimbursement for services and drugs administered to patients covered by Medicaid and Medical Mutual of Ohio (MMOH). The indictment charges that Three Rivers began submitting claims to MMOH falsely under the name “Holzer Infusion Services” in order to avoid the review of Three Rivers claims by MMOH. By the time MMOH discovered that “Holzer” was in reality, Three Rivers, MMOH had paid more than $700,000 in claims to “Holzer,” according to the indictment.

The indictment also charges that Miller caused Three Rivers to file false claims with Medicaid relating to Three Rivers dispensing Synagis to Medicaid patients. It is alleged that fictitious claims were made by Three Rivers for dispensing of Synagis at times when such drug was actually never dispensed.

If convicted, the defendants’ sentences will be determined by the Court after review of factors unique to this case, including the defendants’ prior criminal records, if any, the defendants’ roles in the offense and the characteristics of the violation. In all cases, the sentence will not exceed the statutory maximum and, in most cases it will be less than the maximum.

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