Criminal Justice News

Thursday, April 19, 2012

Medicare Recipient Sentenced for Health Care Fraud

Defendant Used Forged Receipts to Collect More Than $71,000

WASHINGTON—Walt R. Wilson, 42, of Washington, D.C., was sentenced today to six months of home detention after earlier pleading guilty to a charge of health care fraud stemming from a scheme involving more than $71,000 in fraudulent Medicare payments.

The sentence was announced by U.S. Attorney Ronald C. Machen, Jr.; Nicholas DiGiulio, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) for the region including the District of Columbia; and James W. McJunkin, Assistant Director in Charge of the FBI’s Washington Field Office.

Wilson pled guilty in December 2011 before the Honorable James E. Boasberg in the U.S. District Court for the District of Columbia. He agreed to forfeit $71,000 of fraudulently obtained funds. In addition to home detention, Wilson will be placed on three years of probation.

According to the indictment and statement of offense, from about March 2010 to October 2011, Wilson submitted claim forms with forged prescription receipt labels falsely stating that he paid money out-of-pocket for drugs and medicines and was thereby entitled to reimbursement from Medicare. He submitted at least 14 claims seeking reimbursements for prescription drug expenses purportedly paid by him. He attached to these claims forms more than 90 prescription receipts, all but one of which were false and forged. These receipts had been altered to change the amount paid by him from nothing or negligible amounts to hundreds or thousands of dollars.

As a result of the forged prescription receipts and false claims, Wilson fraudulently caused Medicare to pay him more than $71,000 and sought to receive through his false claims more than $98,000.

Within a week after Wilson’s arrest, arraignment, and release pending trial, Wilson received and cashed another Medicare reimbursement check which he had fraudulently requested in the same manner as the indicted checks. This post-indictment check came about from Wilson’s submission of another false reimbursement attaching multiple forged prescriptions.

In announcing the sentence, U.S. Attorney Machen, Special Agent in Charge DiGiulio, and Assistant Director in Charge McJunkin commended the work of special agents with the FBI’s Washington Field Office and HHS-OIG. They also cited the efforts of the staff of the U.S. Attorney’s Office, including Paralegal Specialists Diane Hayes and Sarah Reis, and Assistant U.S. Attorneys in the Asset Forfeiture and Money Laundering Section, as well as Assistant U.S. Attorney Virginia Cheatham, who is prosecuting the case.

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