As we’ve covered quite extensively on the Allegiant Experts Blog, health insurance fraud comes in all forms and is perpetrated by all types of people. Physicians, nurses, healthcare clinic owners, lawyers and so many of their co-conspirators from all walks of life – it appears as if no one is immune to greed, even when it means causing potentially irreparable harm to fellow Americans who so greatly require medical assistance.
You can add 30 year-old, Shawn Thorpe and 46 year-old, Ruben McLain to that growing list of fraudsters. As reported by the Middle District of Florida branch of the United States Department of Justice, the two behavioral health clinic operators recently plead guilty to conspiracy to commit over $1 million in health care fraud. The Winston Salem, North Carolina duo now faces a maximum penalty of five years in prison and a fine of up to $250,000.
In the plea agreements made by both men, it was determined that McLain had been excluded from participating in all federal health care programs due to a federal conviction for health care fraud back in 2011. Nevertheless, he worked with Thorpe to create and manage Coastal Bay – a company that provided medical care to Medicaid patients.
As you may have guessed, it was never disclosed to Medicaid that McLain was excluded from participating in their program. Instead, measures were taken to conceal his true identity. “Julian Winchester” is the alias he came up with so that he could unlawfully perform a number of duties. They included hiring and firing employees, seeing patients and performing other managerial tasks.
As the report explains, McLain regularly travelled between his home in North Carolina and Jacksonville in order to assist with and oversee operations at Coastal Bay. And, as a result, he and his family enjoyed many financial benefits.
“Specifically, McLain had access to a Coastal Bay credit card, which he used to make routine purchases at restaurants, furniture stores, gas stations, and other places in North Carolina, even though Coastal Bay had no operations in North Carolina,” says the report, “In addition, McLain and his immediate family received more than $10,000 in direct payment withdrawals from the Coastal Bay business account.”
In blogs of past, we have even exposed the fraudulent actions of individuals that have lead to the deaths of their unassuming patients. And while no one act of fraud is particularly better or worse than the next, it must be stated that when people’s lives are at stake, fraudulent actions must be punishable in the harshest way possible.
At least, this is how the team, here at Allegiant Experts, feels. And, as a result, we offer our clinical expertise to attorneys who try cases against perpetrators of health care fraud. Our consultants act as specialized members of the litigation or investigation team whose professional contributions are often critical to achieving a fair and just outcome for all parties.
Our experts have been providing expert clinical services for over 15 years – we know we can help your team. For more information about our clinical expert services, please don’t hesitate to call us at 407-217-5831 or email us at info@allegiantexperts.com.