PITTSBURGH—A resident of Washington
County, Pennsylvania pleaded guilty in federal court to a charge of health care
fraud, United States Attorney David J. Hickton announced today.
Randall F. Guzik, 47, of 227 Galbreath
Road, Monongahela, Pennsylvania, pleaded guilty to one count before Senior
United States District Judge Maurice B. Cohill.
In connection with the guilty plea, the
court was advised that from January 2007 to May 17, 2011, in the Pittsburgh
area, Guzik defrauded two health care benefit programs—Highmark Blue Cross and
Blue Shield, a health insurer serving western Pennsylvania (Highmark), and
Anthem Blue Cross and Blue Shield, a health insurer serving Ohio and Kentucky (Anthem)—out
of approximately $550,077.22.
Guzik prepared billings to Anthem for
Highmark insureds residing in Western Pennsylvania for health care services
such as conventional joint x-rays that were false in that no conventional joint
x-rays were provided, the dates of the services were fabricated, the services
were not provided in the locations represented on the billings, and the health
care providers listed on the billings did not perform the services.
Judge Cohill scheduled sentencing for
September 18, 2012 at 2:30 p.m. The law provides for a total sentence of not
more than 10 years in prison, a fine of $250,000, or both. Under the Federal
Sentencing Guidelines, the actual sentence imposed is based upon the
seriousness of the offense and the criminal history, if any, of the defendant.
Pending sentencing, the court continued
Guzik’s bond.
Assistant United States Attorney Nelson
P. Cohen is prosecuting this case on behalf of the government.
The Federal Bureau of Investigation
conducted the investigation that led to the prosecution of Guzik.
Posts
No comments:
Post a Comment