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Allegiant Experts

Married Florida Couple Pleads Guilty To Health Care Fraud Conspiracy




For most of us, marriage is regarded as a sacred bond between two people who have devoted themselves to each other for life. A strong marriage involves commitment, trust, love and honor. For some married couples, however, the union is one that involves working together to profit off of crime. A married couple from Apopka, Florida has designated themselves as being part of the latter group.

 

Florida couple pleads guilty to multiple counts of fraud.

 

As reported by the Northern District of Alabama branch of the U.S. Attorney’s Office this week, 50 year-old Francene Aretha Gayle pleaded guilty to five counts of unlawful drug distribution, one count of health care fraud conspiracy and one count of wire fraud conspiracy. Gayle’s wife, 48 year-old Schara Monique Davis pleaded guilty to one count of health care fraud conspiracy and one count of wire fraud conspiracy.

 

The plea agreements submitted by both defendants declared that between 2014 and 2020, Gayle worked as a doctor. She operated a multi-clinic practice in the northern Alabama towns of Huntsville, Athens and Killen. Davis owned the practice and served as its business manager. By March of 2020, the Alabama Medical Licensure Commission revoked Gayle’s license and inevitably had all three clinics shut down.

 

“Gayle admitted that she had unlawfully distributed drugs, including oxycodone, hydrocodone, and methadone,” details the report, “Gayle and Davis both admitted to having conspired to commit health care fraud for several years by billing insurers for office visits under Gayle’s name even when she did not see the patients, was not in the same building, and sometimes was not in the same town. The defendants knew that the billing scheme was fraudulent.”

 

The practice was audited in 2015.

 

The audit was carried out by Blue Cross Blue Shield of Alabama. During the audit, Gayle was found to be absent while other staff members were seeing patients. Meanwhile, all of the office visits were being billed under Gayle’s name. As a result, Blue Cross flagged the issue and Gayle promised to stop the false billings. Nevertheless, the fraudulent claims continued over the course of the next four years. In total, the couple bilked Medicare, Medicaid and Blue Cross of more than $2.3 million.

 

Gayle and Davis also admitted to having conspired to commit wire fraud. In March 2020, Gayle’s Alabama medical license was revoked. This was due to concerns about her prescribing and billing practices. Months later, Gayle and Davis applied for both the Paycheck Protection Program (PPP) and Economic Injury Disaster Loan (EIDL) program. They obtained more than $450,000 in COVID-19 disaster relief funds.

 

“Those funds were designed to stabilize businesses struggling because of the pandemic,” the report unveils, “In their funding applications, Gayle and Davis certified that their medical practice needed the money because of economic uncertainty or injury caused by the pandemic. In reality, Gayle and Davis’s practice had closed, and they used COVID-19 funds they received on other things.”

 

Are you an attorney who is currently working a healthcare fraud case?

 

The clinical experts at Allegiant Experts can help you! We coordinate and support courageous whistleblowers that shine lights on fraud, waste and abuse. Contact us today to schedule a complimentary consultation. Please don’t hesitate to give us a call at 407-217-5831. You may also email us at info@allegiantexperts.com.

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