Detroit, Michigan - A Michigan patient recruiter was sentenced to 60 months in prison Wednesday for her role in a scheme involving approximately $1.5 million in fraudulent Medicare claims for home health care that were procured through the payment of kickbacks.
Assistant Attorney General Brian A. Benczowski of the Justice Department’s Criminal Division, U.S. Attorney Matthew Schneider of the Eastern District of Michigan, Special Agent in Charge Timothy R. Slater of the FBI’s Detroit Field Office, Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office and Special Agent in Charge Manny Muriel of the IRS Criminal Investigation (IRS-CI) Detroit Office made the announcement.
Sophia Eggleston, 57, of Detroit, Michigan, was sentenced by U.S. District Judge Bernard A. Friedman of the Eastern District of Michigan, who also ordered Eggleston to pay approximately $1.5 million in restitution. In November 2018, following a three-day trial, Eggleston was found guilty of one count of conspiracy to receive health care kickbacks and two counts of receipt of health care kickbacks.
According to evidence presented at trial and at the sentencing hearing, from 2009 to 2012, Eggleston and her co-conspirators engaged in an illegal kickback scheme to defraud Medicare of approximately $1.5 million through fraudulent home health claims. The evidence showed that Eggleston solicited and received kickbacks in exchange for referring Medicare beneficiaries to serve as patients at a home health agency owned by her co-conspirators. Eggleston’s co-conspirators then submitted fraudulent claims to Medicare for home health services that were purportedly provided to those beneficiaries.
The court ordered that Eggleston repay as restitution the total amount that the home health agencies received from the Medicare program from her referrals.
The FBI, HHS-OIG and IRS-CI investigated the case, which was brought as part of the Medicare Fraud Strike Force under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. Trial Attorney Howard Locker of the Fraud Section prosecuted the case.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.