CFO and VP Sentenced in Nationwide Worker's Compensation Fraud Scheme

[nitpicker]

https://www.justice.gov/usao-sdtx/pr/cfo-and-vp-sentenced-nationwide-workers-compensation-fraud-scheme

Department of Justice
U.S. Attorney’s Office
Southern District of Texas

FOR IMMEDIATE RELEASE

Friday, July 21, 2017

CFO and VP Sentenced in Nationwide Worker's Compensation Fraud Scheme

HOUSTON – Two officials with Team Work Ready (TWR) have been ordered to federal prison for conspiracy, health care fraud, wire fraud and money laundering, announced Acting U.S. Attorney Abe Martinez along with Special Agent in Charge Maximo Eamiguel of the U.S. Postal Service - Office of Inspector General (USPS-OIG), Special Agent in Charge Steven Grell of the U.S. Department of Labor (DOL) – OIG, Special Agent in Charge Rick Goss of IRS-Criminal Investigation (CI), Special Agent in Charge James Werner of the Department of Veterans Affairs (VA) – OIG, and Special Agent in Charge David J. Green of the Department of Homeland Security (DHS) – OIG. A federal jury deliberated for 14 hours following a 16-day trial before convicting one of the TWR founders and chief financial officer (CFO) Pamela Annette Rose, 55, and the clinic’s vice president of operations Frankie Lee Sanders, 55, along with CEO Jeffrey Eugene Rose Sr., 54, on Oct. 17, 2016.

Today, U.S. District Judge Ewing Werlein Jr., who presided over the trial, handed Sanders a 300-month sentence, while Pamela Rose will serve a 120-month-term. They will both also be required to serve a term of three years of supervised release following completion of the prison terms. The evidence presented at the hearing included reference to various audio recordings obtained during the investigation and large volumes of documents obtained during the investigation. Pamela Rose was ordered to pay a $14,537548.54 in restitution, while Sanders is to pay $13,365,525.38. In handing down the sentence, Judge Werlein noted the seriousness of health care fraud and the need to deter those involved in this crime. Jeffrey Rose will be sentenced at a later date.
(snip)

TWR had clinics in five states including Federal Work Ready in Houston, Alamo Work Ready in San Antonio and Bayou Work Ready in New Orleans, Louisiana. During the criminal trial, the jury heard testimony from 38 witnesses including former patients of TWR clinics, former employees of TWR clinics, various experts and special agents from the USPS-OIG and IRS-CI. According to testimony, TWR submitted approximately $9.6 million in false and fraudulent claims from four of its clinics for physical therapy services that were not provided. The claims were submitted under the Federal Employees Compensation Act (FECA) health care benefit program which is administered by the DOL - OWCP.

DOL-OWCP's chief fiscal officer explained to the jury at the start of the trial that FECA does not pay for professional services performed by unlicensed aides which is why DOL-OWCP requires the enrollment of all licensed professionals providing services to injured federal employees, including copies of professional licenses. He testified that the FECA program only considers chiropractors as physicians when they treat spinal subluxation. Otherwise, chiropractors are considered equivalent to physical therapists and may provide physical therapy under the direction of, and as prescribed by, a medical doctor. Specifically, in relation to this case, the DOL-OWCP would not have paid millions of dollars for the physical therapy services billed by TWR if they had known that the services were not provided as described in the claims submitted to DOL-OWCP.
(snip)

[DK504]

1. YES!!!

Now go after all the other ones.

While they are fat and happy, there are people living in agony that can't get the proper care.