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The FBI recently announced that Helene Michel, owner of medical equipment company Medical Solutions Management Inc. (MSM), has been sentenced to 12 years in federal prison for conspiracy to commit health care fraud, health care fraud, and HIPAA identity theft crimes. Michel was also ordered to forfeit $1.3 million that was seized by the government when she was indicted (h/t PHIprivacy.net).
Between April 2003 and March 2007, Michel owned and operated MSM, and apparently used her position as a medical equipment company owner to enter New York nursing homes in order to steal patient records. She also apparently posed at various times as a doctor, a nurse practitioner, and a wound care expert, and even accompanied doctors on rounds.
Michel then apparently used the stolen medical records to submit $10 million in false Medicare claims. "For example, in one instance, Michel used fraudulent drawings and measurements to support a Medicare claim for the cost of fitted boots for a legless patient. ... In the event that Medicare denied an MSM claim, Michel submitted an appeal of the denial supported by additional stolen and altered patient records," the FBI states.
According to the FBI, Michel spent the funds resulting from the Medicare claims to purchase a multi-million dollar home, luxury cars, and designer handbags. "[Michel] was a con woman, deceiving patients and administrators alike as she trolled for the information she used to submit fraudulent claims to Medicare to support her extravagant lifestyle," United States Attorney Loretta E. Lynch said in a statement. "Through her scheme she violated the privacy of over a thousand patients and stole Medicare funds dedicated to preserving the health of our seniors and other citizens."
Etienne Allonce, Michel's co-defendent and the co-owner of MSM, remains a fugitive and is believed to have fled the country.