The investigating authorities have praised the sentencing to seven and half years in prison of healthcare professionals accused of gross criminal activities. Further, they praised the court’s decision to size properties and cash by the state from the accused. These properties were acquired with illegally acquired money, and the court’s decision was thus welcomed to tame other people using dubious means to get rich out of the taxpayers’ money. Apart from the jail term, the defendant will have to endure forfeiture of property and cash amounting to 3 million dollars, vehicles, properties in various counties, and pay 24 million dollars in restitution costs.
The judgment was following the events that lead to him pleading guilty in 2019. He pleaded for charges of healthcare fraud, conspiracy to commit healthcare fraud, conspiracy to illegally distribute Suboxone, which is a controlled substance, obtaining a controlled substance through fraud and money laundering. Mr. Sheridan, who was accused together with other accomplishes herein this case is the only proprietor of Braking Point Recovery Center. The facility was famous for offering services to drug addict recovering patients and had operations Ohio. Further, it operated drug and substance rehabilitation centers. The proprietor controlled these businesses alone, although he had created business relationships with other facilities offering support services. The facilities further provided detox services to inpatient and outpatient clients as well as living rehabilitation homes or sober homes. Sober homes are crucial in caring for the patients recovering to keep off drugs and alcohol.
Although Mr. Sheridan was a certified service provider, he was bound by Ohio Medicaid and mental health department programs, he did not practice professionally. Instead, he conspired to defraud the programs by presenting falsified claims and illegally administering controlled drugs to patients. In more than two years from January 2015, Mr. Sheridan and co-accused conspired to defraud the program by submitting 134 thousand cases of claims for more than 48 million dollars’ worth of services that were not justified. However, it was established Medicaid had paid the defendants through their facilities more than 31 million dollars before suspending the payment in 2017. The purported services were on drugs and alcohol treatment to the beneficiaries of the healthcare insurance program.
The indictment and prosecution proved beyond a reasonable doubt that the defendant used dubious means to defraud taxpayers by presenting claims for reimbursement with the prices of drugs and services significantly inflated. The conspiring criminals were coding the services in the system to reflect highly-priced services, although they had not been provided. There were also document audit queries as the majority of the claims submitted had no supporting documents to support the reimbursement sufficiently. Further, the scheme used to make claims for invalid or illegal diagnosis. Patients would be diagnosed with conditions that did not exist. Sometimes the purported diagnosis was not carried at all. In other instances, it was revealed diagnosis bills originated from an unauthorized physician. Consequently, the patients were put on drugs that were not necessary or patients billed for drugs not used.
Among other fraudulent activities, the defendant, together with his co-accused, offered treatment to patients at unlicensed inpatients beds. There were also severe violations of procedures and professional conduct elucidated by the indictment regarding the handling of the drugs. The bills presented for reimbursement showed Suboxone, a controlled substance was abused as it was prescribed to all patients who came to the facility. More so, the investigators proved there were indeed unauthorized treatments carried out by unlicensed physicians on the patients, and the claims were billed to Medicare program. A revelation of systematic billing on quotas of 4-5 hours daily for unnecessary treatments in the facility was even more shocking. It is not possible to treat all the patients with equal amounts of the same drugs for a corresponding period of hours every day, even when their conditions vary. The court heard there were instances of invalid bills of case management presented.
These cases presented more evidence of patient’s getting bills for inpatient services but were provided with outpatient services to increase the value of the claims. Mr. Sheridan was again convicted for using another physician’s license to commit crimes of dispensing more than 3,000 Suboxone doses without the licensee seeing the patients or prescribing the drugs. The courts established he transacted more than 6 million dollars of proceeds from these crimes of healthcare fraud and conspiracy. The defendant pleaded guilty on healthcare fraud, conspiracy to commit healthcare fraud, conspiracy to distribute Suboxone obtaining a controlled substance through fraud and money laundering. His admission led to the conviction and sentencing to seven and a half years in jail together with the fine and forfeiting the properties he acquired using the proceeds of crime. The case of Braking Point Recovery Center conspiring to defraud the vulnerable is one of the many that continues to reach the justice system for determination. Healthcare programs such as Medicare could be losing billions of dollars to unscrupulous businesses individuals who should be acting as the watchdog against healthcare fraud and illegal drug use.
Report any unlawful use Suboxone and any other controlled substance abused out there. More so, report facilities that are acting like Braking Point Recovery center to exploit the patients and induce more drugs on them. If you are a professional healthcare practitioner, do not share your license. If you suspect anyone is using your identity plan or commit a crime, report immediately. It is illegal for healthcare owners to take advantage of the patients to commit crimes. There are legal consequences of committing these crimes, including being sentenced to jail and paying fines. The proprietors can also lose operating licenses, and their facilities are removed from the list of services providers to Medicare beneficiaries in the future
Charges of healthcare fraud, conspiracy to commit healthcare fraud, conspiracy to illegally distribute a controlled substance such as Suboxone, obtaining a controlled substance through fraud and money laundering are severely punishable. Individuals wrongly accused of healthcare fraud and money laundering can get justice in court by engaging a competent team of defense lawyers. Healthcare Fraud Group has been providing the best lawyers in court representation for professionals facing such criminal charges for years. Talk to our criminal defense attorneys who have a track record of diligently representing clients and getting justice. Make a call to 888-402-4054 to speak to a legal expert in the healthcare malpractices at Healthcare Fraud Group now.