Georgia Nurse Practitioner Faces Healthcare Fraud and Identity Theft Charges

A Stone Mountain, Georgia nurse practitioner practitioner faces charges for healthcare fraud, false billings, and identity theft.

Daphne Patterson was indicted by a federal grand jury on charges of healthcare fraud and identity theft related to false billings to insurance companies between May 2013 and September 2014.

Patterson ran the Healthier 4 U Wellness Center in Stone Mountain. According to the federal indictment, she falsely billed major insurance companies, including Aetna, Humana, Blue Cross Blue Shielf, and United Healthcare, for $2.2 million. Most of the fraudulent billings were for allergy tests for at least 20 people, which she never performed. According to the indictment, Patterson “sought reimbursement for at least approximately $2.2 million for the various allergy tests and treatments that had not been provided to the health care benefit program beneficiaries.”

“The patient might not know the insurance company was being charged for this,” former federal prosecutor Bob Brennan said. “Medical identity theft is (a) very fast-growing crime.”

“In total, Patterson received more than $1 million from the health care benefit programs as a result of the fraudulent claims,” the healthcare fraud indictment alleges.

Based upon these allegations, Patterson also likely faces disciplinary action by the Georgia Board of Nursing.

Healthcare Fraud Is Expensive for Government and Victims

According to the Federal Bureau of Investigation, healthcare fraud costs the United States an estimated $80 billion per year. As the costs of healthcare go up, and national healthcare spending surpasses $2.7 trillion, it is more important than ever to report Medicare, Medicaid, and healthcare fraud.

Here are some scams to watch out for that might make you, your insurance company, or Medicare/Medicaid, the victims of healthcare fraud:

• Medical Equipment Fraud: Equipment manufacturers offer “free” products to individuals. Insurers are then charged for products that were not needed and/or may not have been delivered.
• “Rolling Lab” Schemes: Unnecessary and sometimes fake tests are given to individuals at health clubs, retirement homes, or shopping malls and billed to insurance companies or Medicare.
• Services Not Performed: Customers or providers bill insurers for services never rendered by changing bills or submitting fake ones.

Senior citizens can be particularly vulnerable to Medicare fraud, as many elderly people have long-term health problems, and rely on social services like Medicare to provide their care.

The Strom Law Firm Protects Healthcare Fraud Whistleblowers in South Carolina and Georgia

Common whistle blower actions include:

• Medicare fraud, Medicaid fraud, and other healthcare fraud with insurance companies,
• defense contractor fraud, and
• other kinds of fraud.

Bolstered by amendments passed by Congress in 1986, the law has armed private citizens who have independent and direct knowledge of fraud, with a weapon to prosecute government contractors and others who are defrauding the Government.

If you have first-hand knowledge of government or healthcare fraud occurring at your place of employment or your doctor’s office, the attorneys at the Strom Law Firm can help protect your rights. In order to help the government provide the best possible services, Medicaid, Medicare, and healthcare fraud must be reported as soon as possible. The attorneys at the Strom Law Firm understand the complexity of qui tam and whistleblower suits, and we offer free, confidential consultations to discuss the facts of your case. Contact us today. 803.252.4800