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Co-Conspirator In Health Care Fraud Scheme Faces Harsh Prison Sentence

They say “birds of a feather flock together”. They also say “monkey see, monkey do”. Neither of these idioms is generally uttered in a complimentary way. They are often used to describe someone who is either copying or acting like another person who is a bad influence.

When it comes to the law, you can’t sit idly by while someone you know is committing a crime and not expect to be held accountable. And, of course, you can’t conspire to take part in the illegal activity and not expect to be punished if caught.

62-year-old Marcia Ramsier Arthurs found that out the hard way, earlier this week. As the Western District of Pennsylvania branch of the United States Department of Justice reports, Arthurs is the girlfriend of Paul Michael Hoover, a former Pennsylvania-licensed physician. In federal court, on Monday, she was sentenced to a 63-month prison term for her role in a health care fraud scheme the two carried out together.

Arthurs was found guilty of several charges.

Among the charges Arthurs was convicted of are conspiracy to illegally distribute oxycodone, conspiracy to commit health care fraud, conspiracy to commit money laundering and theft of public money. In addition, she has been ordered to pay restitution to the Social Security Administration totaling $48,617.00. She must also forfeit any interest she had in assets totaling approximately $1.2 million in U.S. currency, gold, silver and real property.

The court heard evidence that Arthurs and Hoover conspired to illegally distribute oxycodone, commit health care fraud and launder their drug proceeds. The illegal activity took place between March 26, 2015 and June 22, 2018. Every three months or so, the couple traveled from California to operate a pill mill in Coraopolis, Pennsylvania for a day or two.

Arthurs and Hoover illegally distributed opioids.

During their stays on the west coast, Hoover would write illegitimate oxycodone prescriptions for people in exchange for cash. Arthurs helped out by writing the prescriptions, counting the cash and helping to manage the pill mill. Upon returning to California, Hoover and Arthurs would receive money orders for oxycodone prescriptions from Pittsburgh residents. After receiving their payments, the two would mail illegitimate prescriptions to the buyers.

“Hoover also conspired with Arthurs to commit health care fraud by signing preauthorization forms and submitting the forms to Medicare and Medicaid health plans, which then paid for the cost of the illegitimate prescriptions,” reports the DoJ, “Hoover and Arthurs also conspired to launder the proceeds from their drug distribution operation.”

Arthurs made out with a lot of cash.

The DoJ report also reveals that between October 2012 and July 2018, Arthurs knowingly took benefits totaling $48,617.76 and converted it for her own use. The money belonged to the Social Security Administration in Social Security Title II and Supplemental Security Income (SSI).

“The defendant’s actions were without authority in that she made false representations to the Social Security Administration in order to wrongfully obtain these benefits, including reporting false information about her living and financial arrangements with Hoover,” says the DoJ report, “Hoovers was previously sentenced to a term of imprisonment of 136 months and restitution to Medicare, Medicaid, and the Social Security Administration totaling $406,760.75.”

Are you an attorney who is currently trying a health care fraud case?

Contact Allegiant Experts to find out how our clinical expertise may help your case. Please don’t hesitate to give us a call at 407-217-5831 or email us at info@allegiantexperts.com.

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