Chandler Medicare thief gets 3 years in jail SanTan Sun News

Chandler Medicare thief gets 3 years in jail

May 11th, 2021 STSN Staff
Chandler Medicare thief gets 3 years in jail
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SANTAN SUN NEWS STAFF

A Chandler woman has been sentenced to federal prison after pleading guilty to filing thousands of fraudulent claims for Medicare benefits totaling more than $4 million.

Frances Jones, 52, was ordered to spend three years behind bars for a scam she ran between 2011-18.

Jones had been the owner of Oxicheck Northwest, a provider for durable medical equipment and used her business to bill Medicare for false prescriptions for her devices.

Jones spent the profits she netted from the scheme on vacations, plastic surgery, spa treatments, and casino gambling.

According to federal prosecutors, Jones misused the identification numbers of various doctors to get Medicare to pay for medical equipment that had never been prescribed by them.

She used the credentials of one doctor to file numerous claims valued at more than $2.5 million and later collected $570,000 in reimbursements from those claims.

Jones used the identity of another doctor in California to file 249 claims on behalf of a Medicare beneficiary who lived in Washington State. Even after the patient had died in 2017, Jones continued filing several claims for medical equipment.

The defendant would file claims for doctors who had stopped practicing medicine in Arizona or discontinued writing prescriptions for equipment.

One doctor, who had stopped writing prescriptions in 2012, had $680,000 worth of Medicare claims filed under his name by Jones between 2013-18. Jones was allegedly paid about $117,000 off of those fake claims.

Patients and government auditors eventually noticed discrepancies in billing statements and began to suspect that Jones was overbilling for unnecessary services.

Jones spent years trying to cover her tracks by coming up with various excuses for why her accounting didn’t add up, delaying her case for more than three years in court.

“Defendant perpetuated her fraud scheme by boldly lying to beneficiaries who complained and to law enforcement when they inquired,” prosecutors wrote.

She initially claimed Oxicheck Northwest had made some billing mistakes and promised to correct the errors.

After the Arizona Attorney General’s Office opened an investigation in 2015, Jones told investigators her billing irregularities were caused by a computer glitch. She further blamed Medicare patients for having a “vendetta against her” and accused them of sabotaging her business, court documents show.

Federal prosecutors faulted Jones for cheating a system that’s difficult to police and taking away taxpayer-funded resources that could have been better used to help patients.

In 2020, the Government Accountability Office estimated that about $43 billion in improper payments were processed by the Medicare program.

“Defendant committed flagrant fraud against a system built on trust and designed to provide health care to our vulnerable populations,” prosecutors stated.

U.S. District Court Judge John Hinderaker ordered Jones to pay $862,000 in restitution.

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