The author of multiple books on healthcare compliance was sentenced to federal prison on Tuesday for falsely billing Medicare as part of a $136 million scheme that involved several states, according to the Washington Examiner.
Jean Wilson, 54, was sentenced to ten years in prison followed by three years of supervised release in the United States District Court for the District of New Jersey for her role in a medical billing scheme, including illicit kickbacks and enormous amounts of forged prescriptions.
The superseding indictment alleges that Wilson owned and ran two telehealth companies that paid medical providers to make large orders of orthotic devices and prescription medications for Medicare enrollees who did not require the braces or medication. Prosecutors claimed Wilson, a qualified nurse, signed many of the prescriptions herself.
Wilson and other co-conspirators obtained the supply orders and falsified medicine prescriptions and sold them to alleged marketing companies for an average of $90 per Medicare recipient. These unscrupulous marketing organizations then resold the signed orders to brace suppliers and pharmacies, pressuring patients to take as many braces as possible.
The evidence presented in the lawsuit revealed that bribed medical practitioners working for Wilson signed orders for four or more orthotic braces per beneficiary in over 3,000 patient files. In reality, over 40 beneficiaries received orders for ten or more devices.
Wilson and her collaborators submitted bogus Medicare claims totaling more than $136 million in just two years, with Medicare paying out more than $66 million of that amount.
Reinaldo Wilson, her husband, was sentenced in February to seven years in prison for his role in the scheme. According to court filings, the couple utilized the funds from the scam to buy luxury vehicles, including multiple Rolls-Royces.
Wilson was also ordered on Tuesday to repay $66 million in restitution and forfeit $7.8 million. She had already pled guilty to conspiracy to commit wire fraud and healthcare fraud.
“The defendant—a nurse practitioner responsible for the care and safety of her patients—exploited our health care system, conspiring to submit over $136 million in false and fraudulent claims to Medicare,” said Assistant Attorney General Colin M. McDonald of the Justice Department’s National Fraud Enforcement Division.
“Today’s lengthy sentence underscores the Fraud Division’s commitment to fighting fraud at every turn in order to restore public trust in our institutions,” McDonald told the Washington Examiner. “We will work tirelessly to hold corrupt medical professionals accountable and recover stolen taxpayer dollars for the American people.”
Wilson, a self-described “medical professional legal consultant” and “compliance expert,” has authored multiple books about healthcare fraud. Wilson warned in her book Avoiding Health Care Pitfalls, which is still available on Amazon, that “some entities and individuals will try to use you as a way to make them millions!” Wilson promoted the book as the compliance resource “every healthcare provider should have,” promising readers, “Your license will thank you!”
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