LI Woman Sentenced to 12 Years for $10 Million Medicare and HIPAA Identity Theft Scam

[Erica Absetz <erica () riskbasedsecurity com>]

http://www.longisland.com/news/04-11-13/li-woman-sentenced-to-12-years-for-10-million-medicare-and-hipaa-identity-theft-scam.html

United States District Judge Joseph F. Bianco yesterday sentenced
Helene Michel, a resident of Old Brookville, to 12 years in federal
prison for $10 million ...

United States District Judge Joseph F. Bianco yesterday sentenced
Helene Michel, a resident of Old Brookville, to 12 years in federal
prison for $10 million Medicare fraud and HIPAA identity theft.

Michel, 45, an owner and officer of Medical Solutions Management Inc.
(MSM), a medical equipment company located in Hicksville, used her
position to gain access to nursing homes in Nassau, Suffolk, Queens,
Kings, and Dutchess Counties to steal patient records in violation of
the Health Insurance Portability and Accountability Act (HIPAA).

Michel used the stolen records to create and submit $10 million in
false billings to Medicare for medical supplies and products that were
either not required or not delivered.

In one instance, Michel used bogus drawings and measurements to
support a Medicare claim for fitted boots for a legless patient. In
another instance, she submitted false claims for the purchase of
expensive wound care bandages to treat patients who never had such
wounds.

In response to claims that were denied, Michel submitted appeals to
Medicare, supported by additional stolen and altered patient records.

As part of the scheme, which, according to the evidence at trial,
lasted between approximately April 2003 and March 2007, Michel also
assumed a number of false roles.

“Helene Michel brazenly roamed the halls of dozens of nursing homes,
pretending to be, among other things, a doctor, a nurse practitioner,
and a wound care expert, even going so far as to join patient
evaluations. In reality, she was a con woman, deceiving patients and
administrators alike as she trolled for the information she used to
submit fraudulent claims to Medicare to support her extravagant
lifestyle…,” said Loretta E. Lynch, U. S. attorney for the Eastern
District of N. Y.

Michel’s lavish lifestyle included a multi-million dollar home in an
exclusive neighborhood on the North Shore, a half-million-dollar
pension account, luxury cars and designer handbags.

At the sentencing, Judge Bianco also ordered that Michel forfeit $1.3
million that was seized by the government at the time of her
indictment.

“…Through her scheme she violated the privacy of over a thousand
patients and stole Medicare funds dedicated to preserving the health
of our seniors and other citizens. We, and our law enforcement
partners, will vigorously pursue and prosecute those who seek to
profit by such despicable crimes,” said Lynch.

Assistant U.S. Attorney Charles Kelly said, "There is an epidemic of
ID theft and much of it comes out of health-related places. . . .
There is in the criminal community an insatiable demand for face
sheets that" contain a patient's Social Security and Medicare numbers.
They "have become a cash equivalent on the streets of Long Island
where they are sold at a price per sheet, per patient." According to
some sources, the rate for such face sheets ranges up to $100.

Michel’s co-defendant Etienne Allonce, the co-owner of MSM, was also
charged in the indictment and is believed to have fled from the United
States. He remains a fugitive, listed on HHS-OIG’s Most Wanted List.

Before she was sentenced, Michel told Bianco, "I had in my heart to
help people. . . . If I were sitting on the jury I would convict
myself. . . . I don't understand a lot of things that happened."
Michel's attorney, David Bythewood, is planning an appeal.
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