Man pleads guilty to stealing more than $300,000 in healthcare fraud scheme

ATLANTA – Michael Bang has pleaded guilty to healthcare fraud charges related to a fraudulent reimbursement scheme targeting the Colorado Public Employees Retirement Association (“COPERA”).

“Bang’s stole hundreds of thousands of dollars from a public entity that was at the same time providing him with medical and other benefits,” said U.S. Attorney Byung J. “BJay” Pak.  “Schemes like this can ultimately cost other customers precious resources to which they are entitled.”

“Falsifying prescriptions in order to generate illicit profits at the expense of tax payers will not be tolerated and the FBI will pursue anyone who chooses to do so,” said Chris Hacker, Special Agent in Charge of FBI Atlanta. “Bang was driven by greed and he will now be held accountable for his transgressions.”

According to U.S. Attorney Pak, the charges and other information presented in court: Bang, who from at least 2014 to 2017 was a resident of Atlanta, Georgia, received retiree health benefits from COPERA’s self-funded health insurance program, PERACare.  The prescription coverage portion of the program was administered by Express Scripts.  PERACare provided insurance for current and former Colorado public employees no matter where they lived.

As part of the healthcare fraud scheme, Bang, who at the time was a resident of Atlanta, sought reimbursement for medications through the submission of fraudulent reimbursement forms for medication that he was either not receiving or that was more expensive than the medications he was receiving.  Bang’s scheme involved three Atlanta-area pharmacies.

The reimbursement claim forms that Bang faxed to Express Scripts were fraudulent for a number of reasons:

    The forms themselves were fabricated and submitted by Bang—they were not created by the pharmacies;

    Pharmacists’ signatures on each form were forged or unauthorized reproductions of the signatures of each pharmacist;

    Certain forms contained claims for medications that Bang never received and that never would have been prescribed simultaneously;

    The forms contained prescription numbers that did not match the medication claimed under that number;

    Many reimbursement forms claimed a “fill date” for prescriptions on dates when the pharmacies have no records of filling any prescriptions for Bang; and

    The forms claimed out-of-pocket expenses that were never incurred by Bang.

   

Between May 2014 and December 2017, Bang stole at least $300,000 from COPERA through his fraudulent reimbursement scheme.

On November 7, 2018, Bang, 58, of Mesa, Arizona, was indicted on twenty counts of healthcare fraud, wire fraud, and aggravated identity theft.  He pleaded guilty to one count of healthcare fraud.  Sentencing is scheduled for October 24, 2019, at 3:00 p.m., before U.S. District Judge Steve C. Jones.

In determining the actual sentence, the Court will consider the United States Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for most offenders.

This case is being investigated by the Federal Bureau of Investigation.

Assistant U.S. Attorney Ryan J. Huschka is prosecuting the case.