Sources: Coalition Against Insurance Fraud; Ohio Department of Insurance

Fraud Roundup

Ohio pair indicted for alleged fraud, money laundering tallying $200,000

The Coalition Against Consumer Fraud and the Ohio Department of Insurance reported that two former dental office employees, Alberta Fay Clark and Tammie Creamer, have been indicted for alleged insurance fraud, theft and money laundering totaling approximately $200,000. Clark was indicted on a total of 22 counts and faces 111 years in prison. Creamer was indicted on a total of 20 counts and faces 82 years in prison.

Ohio Insurance Director Womer Benjamin congratulated the department’s investigative team, the Green County Prosecutor’s office and the Xenia Police Department for pursuing appropriate penalites in the case.

The Department opened its investigation in 2005 after receiving a complaint about Creamer from an insurance company, later learning of Clark’s involvement. Both Clark and Creamer are former longtime employees of the dental practice of Clarence Lincoln Thomas III, DDS, located in Xenia, Ohio.

Creamer received free dental work from her employer, but from 2002 to 2005 submitted numerous false claims to her insurer totaling more than $30,000. Clark submitted a $3,000 fraudulent claim in 2002, also for free work performed by the dental office.

The investigation also determined that from 2002 to 2005 Creamer and Clark used various methods to allegedly embezzle nearly $170,000 from the practice. Creamer would purchase business supplies from Wal-Mart but she also made personal purchases, writing checks from the business account to Wal-Mart. Clark prepared numerous “extra” paychecks for herself and Creamer from 2002 to 2005. Due to statute of limitations issues, investigators began reviewing financial records from Jan. 1, 2001, onward.

Consumers and insurance professionals are advised to report suspected insurance fraud by contacting the Ohio Insurance Department’s fraud hotline at (800) 686-1527.

A Michigan Upper Peninsula psychologist is sentenced to two and-a-half years in prison for health insurance fraud. Herman Rummelt pleaded guilty in October to
filing false claims for reimbursement

totaling $853,000.

At his sentencing in federal court yesterday, the 63-year-old Rummelt also was ordered to repay the money. He’ll spend three years on probation once he’s freed from prison.

Source: CAIF

Wis. nurses convicted of filing non-existent Medicaid claims

Two La Crosse, Wis., area registered nurses were convicted recently of filing fraudulent Medicaid insurance claims.

Janice Corbett, 65, of Ontario, Wis., pleaded guilty in Dane County Circuit Court to one count of misdemeanor fraudulent insurance claims, according to Attorney General Peg Lautenschlager’s office.

Rosalie Zahn, 70, of La Crosse, also pleaded guilty to one count of misdemeanor fraudulent insurance claims, according to the attorney general’s office.

Under a plea agreement, Corbett must permanently surrender her Medicaid provider number and pay a $2,500 fine. She already has made restitution of $32,330 and performed 100 hours of community service.

According to the Department of Justice’s criminal complaint, Corbett, a registered nurse, was hired to help provide 24-hour nursing coverage for a La Crosse resident with muscular dystrophy. Corbett continued to submit claims after her employment was terminated June 28, 2002.

The criminal complaint on Rosalie Zahn said that she, as a registered nurse, also was hired to help provide 24-hour nursing coverage for a La Crosse resident with muscular dystrophy. Zahn continued to submit claims after her employment was terminated Nov. 10, 2002.

Under a plea agreement, Zahn must permanently surrender her Medicaid provider number and pay a fine of $1,000. Zahn has already made restitution in the amount of $17,006 and performed 100 hours of community service.

Source: CAIF