Three Sentenced in Scheme to Defraud Medicare

BATON ROUGE, LA—United States Attorney Donald J. Cazayoux, Jr. announced that U.S. District Judge Brian Jackson sentenced Alton Bates, 62, an attorney in Baton Rouge, Louisiana, to 34 months in prison, to pay restitution of $1,063,873 to Medicare, to forfeit the gross proceeds of his scheme to defraud Medicare, and to three years' supervised release after imprisonment. Judge Jackson also sentenced co-defendants Robert Ivory Levy, 59, and Juanita Anderson Hilton, age 42, both of whom are residents of Baton Rouge and were licensed clinical social workers. Levy was sentenced to 15 months' imprisonment, was ordered to pay restitution of $120,946.89 to Medicare, and to serve three years' supervised release after imprisonment. Anderson Hilton was sentenced to three years' probation with a condition that she serve six months in a local halfway house and repay $89,450 to Medicare.

Alton Bates pled guilty on July 21, 2009 to two counts of health care fraud and two counts of paying illegal kickbacks. Levy and Anderson Hilton both pled guilty to one count of health care fraud. Anderson Hilton pled guilty on July 21, 2009 and Levy pled guilty on September 21, 2009.

Alton Bates, Robert Levy, and Juanita Anderson Hilton schemed to defraud the Medicare program by submitting false and fraudulent claims for psychotherapy services that were not provided. In total, the three defendants’ participation in this scheme involved more than 7,700 false claims seeking Medicare payments totaling $3,052,838. Due to the scheme, Medicare program paid more than $1,000,000 to Above and Beyond, LLC, the Baton Rouge company which the defendants operated between 2003 and 2005.

The investigation of Above and Beyond, Bates, Levy, and Anderson Hilton was conducted by the Office of Inspector General for the United States Department of Health and Human Services, the Federal Bureau of Investigation, AdvanceMed, the Zone Program Integrity Contractor for Medicare, and the United States Attorney’s Office. The case was prosecuted by Assistant United States Attorney Rene Salomon.

U.S. Attorney Donald J. Cazayoux, Jr. stated, “Uncovering, investigating, and prosecuting health care fraud is critically important to protecting the solvency of these important medical programs. We will continue the collaborative team approach to fighting these crimes and to putting those who would defraud our Medicare and Medicaid systems in jail.”

The Office of the Inspector General is proud of the three sentences obtained here which send a strong warning to anyone defrauding the Medicare program. “We will continue to investigate and prosecute you,” said Mike Fields, Special Agent in Charge Health and Human Services.

According to FBI Special Agent-In-Charge David Welker: "Crimes such as these continue to drive the cost of healthcare up for the average citizen and most needy. The FBI will continue to work collaboratively with our law enforcement partners to bring these type of criminals to justice in an effort to reduce this type of crime.”

The investigation of similar schemes to defraud the Medicare program is ongoing.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to stopmedicarefraud.gov.