Health Care fraud leads to prison time

Published 9:04 am Thursday, March 25, 2010

RALEIGH – Indicted late last year on the charges of aiding and abetting health care fraud, an Aulander woman will serve the next 46 months behind bars.

Faith Elaine Sumner, 43, entered a guilty plea in federal court in December and was recently sentenced to a prison term of 3 years and 10 months, according to information provided Tuesday by United States Attorney George E.B. Holding of the Eastern District of North Carolina.

Additionally, Sumner, as part of a plea arrangement, was ordered to repay $677,272 in Medicare and Medicaid claims that she admitted to falsely reporting to the government.

She was also be under three years of supervised probation following her release from prison.

In November of last year, the U.S. Attorney’s Office filed a criminal indictment against Sumner. That indictment revealed that Sumner, while employed as the office manager for Preferred Medical Transport of Aulander, unlawfully billed the government in excess of $650,000.

The federal case against Sumner was built around her submitting false claims for reimbursement for ambulatory transports of clients going to and from dialysis treatments. However, transports of dialysis patients are normally of a non-emergency nature and usually performed by a wheelchair accessible van. During the investigation it was found that Sumner falsified trip records and related documents to show that the patient was transported by ambulance for “medical necessity.”

“Health care fraud is an increasing concern as individuals believe it is easy to defraud the government and they will not be caught. This is not true,” Holding said in a press release. “The government, both at the state and federal levels, have investigators to seek out fraud, when it occurs, and my office stands ready to prosecute those who try to take advantage of the system.”

The maximum penalty for the charge is up to 10 years imprisonment followed by up to three years of supervised release and a fine of up to $250,000.

Investigation of this case was conducted by the United States Department of Health and Human Services and the North Carolina Department of Health and Human Services.