Businesswoman Admits Guilty to Health Care Fraud and Tax Evasion Accusations and Agrees to Reimburse 20.3 Million U.S. Dollars to Settle the Civil Claims

Businesswoman Admits Guilty to Health Care Fraud and Tax Evasion Accusations and Agrees to Reimburse 20.3 Million U.S. Dollars to Settle the Civil Claims

Tampa, Florida – On 4th February 2021, Maria Chapa Lopez, United States Attorney, reported that Kelly Wolfe from Indian Rocks Beach, age 49, had admitted guilt to a scheme to carry out health care fraud and filing a fake tax return. Kelly Wolfe faces a maximum imprisonment of thirteen years in federal prison. The date of conviction has not been scheduled yet.

Besides her criminal indictments, Kelly Wolfe and Regency, Inc., her company, have consented to reimburse up to 20,332,516 U.S. dollars, to resolve accusations that Kelly Wolfe and Regency broke the False Claims Statute in several ways, like forging documentation in order to falsely create DME (durable medical equipment) corporations to charge for medically unrequired DME devices, and take part in inappropriate advertising practices that breach the Anti-Kickback Act. The civil resolution amount is based on Kelly Wolfe and Regency’s capacity to pay.

As per the court affidavits, Kelly Wolfe and her co-schemers utilized Regency to create dozens of durable medical equipment supply firms—or, instead, durable medical equipment fronts—by deception and trickery. The conspiracy included putting the durable medical equipment fronts in straw owners’ names. By covering up the true fronts’ ownership, Kelly Wolfe’s co-schemers secretly gained numerous firms’ control. Through such control, they jointly submitted more than 400 million U.S. dollars in illicit durable medical equipment claims to the Medicare program and CHAMPVA (the Civilian Health & Medical Program of the Veterans Affairs Department). The schemers depended on the guise of telemedicine to elucidate the strangely high volume of submissions, when, in reality, they had simply kick-backed physicians to certify them. Generally, the physicians had no interaction, such as telehealth interaction, with the recipients. Kelly Wolfe further confessed that, for the 2017 tax year, she had bought several personal services and items with Regency’s funds. Instead of properly reporting this as revenue to the IRS (Internal Revenue Service), Kelly Wolfe misleadingly categorized her personal spending as alleged business expenses.

This prosecution, originating from the national “Operation Brace Yourself” takedown, includes one of the biggest health care fraud conspiracies in American history. Florida’s Middle District is playing a key role in these historic and countrywide enforcement actions. Joint efforts between local, state, and federal partners have led to criminal indictments against twelve accused people in Florida’s Middle District.

The Justice Department – Civil Division Deputy Assistant Attorney General John V. Coghlan stated that the Department is devoted to ensuring that federal health care system providers never place their financial profits over patients’ clinical desires. Deputy Assistant Attorney General John V. Coghlan further noted that when medical specialists and firms intentionally or knowingly carry out fraud to maximize their returns, we will hold them responsible for their illegal conduct.

Florida’s Middle District United States Attorney Maria Chapa Lopez stated that fraud and dishonesty in the nation’s healthcare program are unacceptable and illegal. U.S. Attorney Lopez further assured that the U.S. Attorney’s Office would aggressively continue to work with their investigative partners to fight and eradicate these unlawful practices to ensure that patients get their deserved optimum care.

Special Agent Omar Pérez Aybar in Charge of the United States Health & Human Services Department – Office of Inspector General stated that this ruinous telefraud conspiracy’s objectives were stopped by the excellent partnership of their law enforcement partners. Special Agent Omar Pérez Aybar further noted that these pleas of guilty and the forfeiture of numerous millions of U.S. dollars back to the United States Treasury demonstrated their devotion to stop such ruinous fraud conspiracies and to bring to justice the fraudsters.

The FBI Tampa Division Special Agent in Charge Michael McPherson stated that the Federal Bureau of Investigation is incredibly focused on revealing those who defraud government-subsidized healthcare programs. Special Agent in Charge Michael McPherson further noted that U.S. taxpayers should be assured the Federal Bureau of Investigation and its law enforcement partners are vigorously working to safeguard federally-funded healthcare programs from fraud and cupidity.

IRS – Criminal Investigation Special Agent in Charge Brian Payne stated that law-abiding and honest citizens are tired of the likes of those using fraud and deceit to enrich themselves. Special Agent in Charge Brian Payne further noted that defrauding the health care program effectively robs everyone, and tax fraud compromises the American tax system’s integrity. People who participate in these frauds should know they would never go unnoticed and would be held answerable.

Special Agent David Spilker in Charge at the Veterans Affairs Department – Office of Inspector General stated that the VA OIG’s continual oversight of the Civilian Health & Medical Program of the Veterans Affairs Department, which gives community care to the kin of disabled veterans, is among the agency’s top priorities since it protects the integrity of Veteran Affairs Department’s health care systems. Special Agent David Spilker further noted that as documented in the indicting documents, the accused person’s criminal actions led to a massive fraud being executed against both the Civilian Health & Medical Program of the Veterans Affairs Department and the Medicare program, ultimately affecting the receivers of those programs. The Veterans Affairs Department – Office of Inspector General, applauds the extensive partnership between their law enforcement partners in this crucial investigation.

The United States Assistant Attorney Kristen Fiore and the United States Assistant Attorney James Muench are criminally prosecuting this case. United States Assistant Attorney Carolyn B. Tapie and Trial Attorney Daniel A. Schiffer of the Justice Department, Civil Division – Commercial Litigation Branch, with assistance from the Department of Health and Human Services – Office of Inspector General, the Department of Veterans Affairs – Office of Inspector General, the FBI, and the IRS-CI (Internal Revenue Service – Criminal Investigation) civilly pursued the matter. The United States prior received an emergency temporary restraining order and a preliminary injunction ordering the conduct and assets of Kelly Wolfe, Regency, and numerous of their co-schemers, in a civil injunctive suit prosecuted by the United States Assistant Attorney Carolyn B. Tapie and the United States Assistant Attorney Sean P. Keefe.

The civil resolution involves the settlement of accusations submitted by Condra Albright, a previous Regency worker, under the qui tam or relator provisions of the False Claims Statute against Kelly Wolfe and Regency. Condra Albright will get 23% of the civil recovery as her constitutional reward because of the resolution. The accusations settled by the resolution are mere allegations, and there has been no determination of responsibility.

Breaking the Controlled Substance Act, the Anti-Kickback Statute, or conspiring to commit health care fraud by defrauding federally-funded health care programs such as Medicaid, TRICARE, or Medicare programs is a serious crime. Any individual who commits these crimes breaks the law and is severely punished or fined if found guilty of the accusations. When indicted for these crimes, you must seek the best legal representation or assistance to protect and pursue your rights. Hire our team of top-rated and qualified defense and criminal attorneys if you want the finest legal representation and advice, which will lead to achieving positive results for your matter. At Health Care Fraud Group, we comprise a highly experienced team of lawyers with many years of experience in dealing with Health Care Fraud related cases related to the Federal Health Care Program; they are very knowledgeable about civil and federal cases. The defense lawyers are well recognized across the United States because of their excellent work and professionalism when handling and dealing with health care fraud cases and investigations. They are well-equipped with previous knowledge of every aspect of Health Care fraud defense, medical, and legal matters.

Our offices are always open, and we are well-prepared and ready to commence your defense immediately. We are the most sought-after law firm because we are recurrently updating our practices and knowledge in order to act swiftly in your matter without the need for constant legal consultations. We offer a safe and quick evaluation of your matter and act swiftly to collect, acquire, and assemble the necessary and key particulars about your case in the government’s investigations. When hired, we will assist you and your team to come up with the best and right decision. Our highly proficient team of attorneys will support and guide you when necessary in anything you may need to know and train your team to effectively support your criminal defense; because there are many crucial mistakes, you should avoid facing a health care fraud investigation. Also, we will offer you and your team with detailed legal assistance and defense in cases and investigations that are in charge and even those in other institutions or firms that cover the IRS and the FBI, and investigations and matters that are under the jurisdiction of the CMS, OIG, DHHS, DOJ, and DEA. Besides, we will investigate potential health care fraud and help keep both you and your career safe. Our highly qualified attorneys at the Health Care Fraud Group are conversant and clearly understand the need to prove innocence after the accusation of any crime. For any legal representation, advice, or help you may need, contact us at 888-402-4054.

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