The Accused Individuals Were Indicted As Part Of A Countrywide Health Care Fraud And Opioid Action.
Great Falls – On 21st April 2021, Acting United States Attorney Leif Johnson announced that two Montana-based nurse practitioners had pleaded guilty to accusations that they schemed to steal the Medicare program of millions of U.S. dollars in a conspiracy in which they obtained money to sign deceitful orthotic braces’ orders.
On 21st April 2021, Janae Nichole Harper, age 34, from Kalispell, admitted guilt to a scheme to perpetrate health care fraud. Janae Harper was a certified nurse practitioner in Missouri, Montana, South Carolina, Nevada, and Wyoming and was registered as a medical provider with the Medicare program.
Mark Allen Hill, from Edinburg, North Dakota, age 54, and whose address of record for contribution in Medicare was in Cut Bank, Montana, admitted guilty on 20th April 2021 to a scheme to perpetrate health care fraud. Mark Hill was a certified nurse practitioner in Iowa, Montana, Minnesota, Maine, South Dakota, North Dakota, and Washington.
Mark Hill and Janae Harper face a maximum imprisonment term of ten years and a 250,000 U.S. dollar fine each.
Brian M. Morris, Chief U.S. District Judge, presided over the trial.
Chief Judge Morris scheduled both Janae Harper’s and Mark Hill’s sentencing for 27th July 2021 and continued their release.
Janae Harper and Mark Hill were among those charged in a historic countrywide opioid and health care fraud enforcement takedown announced on 30th September 2020 by the U.S. Justice Department. The enforcement takedown involved 345 indicted accused persons across 51 U.S. districts, including over 100 physicians, nurses, and additional certified medical professionals.
These accused persons were indicted for submitting over 6 billion U.S. dollars in fraudulent and false claims to federally-funded health care systems and private insurers, including over 4.5 billion U.S. dollars linked with telemedicine. Telemedicine employs telecommunications to offer healthcare services remotely.
In court affidavits filed in Janae Harper’s matter, the government purported that between 18th November 2017 and 16th July 2019, Janae Harper worked with certain telemedicine and staffing firms to perpetrate health care fraud and obtained money to rubber-stamp brace orders that were made by telemarketers with no medical certification or training. Janae Harper regularly rubber-stamped these orders for the Medicare program recipients irrespective of medical necessity. Janae Harper rubber-stamped about 7,673 brace orders, which led to 8,259,849 U.S. dollars charged to the Medicare program, of which the Medicare program reimbursed about 4,307,934 U.S. dollars. Janae Harper was reimbursed more than 94,395 U.S. dollars for the orders she rubber-stamped.
In court affidavits filed in Mark Hill’s matter, the United States purported that between 15th October 2017 and 24th April 2019, Mark Hill worked with certain telemedicine and staffing firms to execute health care fraud and obtain money to rubber-stamp unnecessary brace orders for the Medicare program recipients irrespective of medical necessity, regularly without ever meeting or talking to the Medicare program recipient to establish if the braces were medically required. Mark Hill signed about 7,097 brace orders, which led to 10,055,436 U.S. dollars charged to the Medicare program, of which the Medicare program reimbursed about 5,054,866 U.S. dollars. Mark Hill was reimbursed more than 124,900 U.S. dollars for the orders he rubber-stamped.
The matter’s prosecution is being handled by U.S. Assistant Attorney Michael A. Kakuk, Trial Attorney Darren Halverson, and ex-Trial Attorney Robyn Pullio of the Fraud Section – Criminal Division of the Department of Justice.
The enforcement takedowns were steered and harmonized by the Criminal Division, Fraud Section – Health Care Fraud Unit, in collaboration with its Health Care Fraud and ARPO (Appalachian Regional Prescription Opioid) Strike Force program, and its main law enforcement partners, the HHS-OIG (the U.S. Health & Human Service Department – Office of the Inspector General), the U.S. Attorneys’ Offices, the FBI, and U.S. Drug Enforcement Administration. This was part of the department’s continuing efforts to fight the overwhelming effects of the opioid crisis and health care fraud.
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