Patient Recruiter Convicted in $1.1 Million Kickback Scheme

On Friday, Nov. 2, a federal jury found a patient recruiter guilty for her role in a scheme involving approximately $1.1 million in fraudulent Medicare claims for home health care that were procured through the payment of kickbacks. 

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Matthew Schneider of the Eastern District of Michigan, Special Agent in Charge Timothy Slater of the FBI’s Detroit Division, 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, 56, of Detroit, Michigan, was convicted of one count of conspiracy to receive health care kickbacks and two counts of receipt of health care kickbacks following a three-day trial.  Sentencing has been scheduled for Feb. 6, 2019 before U.S. District Judge Bernard Friedman of the Eastern District of Michigan, who presided over the trial.

According to evidence presented at trial, from 2009 to 2012, Eggleston and her co-conspirators engaged in an illegal kickback scheme to defraud Medicare of approximately $1.1 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 claims to Medicare for home health services that were purportedly provided to those beneficiaries.

The FBI, HHS-OIG and IRS-CI investigated the case.  Trial Attorneys Stephen Cincotta and Howard Locker of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  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.

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Author: November 5, 2018