Newark, NJ – A Georgia nurse practitioner who operated two telemedicine companies has been sentenced to 10 years in federal prison for her role in a massive Medicare fraud scheme that resulted in more than $136 million in fraudulent claims and over $66 million in taxpayer losses, the U.S. Department of Justice announced.
Jean Wilson, 54, of Richmond Hill, Georgia, was also ordered to pay $66 million in restitution after pleading guilty to conspiracy to commit wire fraud and health care fraud. The case was investigated by the FBI Newark Field Office and the U.S. Department of Health and Human Services Office of Inspector General.
Fraud scheme generated millions in false claims
According to court documents, Wilson owned and operated two telemedicine companies between 2017 and 2019. Prosecutors said she and others paid illegal kickbacks to medical providers to sign orders for orthotic braces and prescriptions for Medicare beneficiaries who did not medically need the equipment or drugs.
Wilson also signed many of the fraudulent prescriptions herself before selling the signed orders to marketing companies for approximately $90 per Medicare beneficiary. Those companies allegedly resold the orders to brace suppliers and pharmacies, which then billed Medicare for medically unnecessary products.
Investigators said practitioners working for Wilson signed orders for four or more orthotic braces for more than 3,000 beneficiaries, while over 40 beneficiaries received orders for 10 or more braces.
Luxury vehicles purchased with fraud proceeds
“The defendant—a nurse practitioner responsible for the care and safety of her patients—exploited our health care system, conspiring to submit over $136 million in false and fraudulent claims to Medicare,” said Assistant Attorney General Colin M. McDonald of the Justice Department’s National Fraud Enforcement Division.
“Today’s lengthy sentence underscores the Fraud Division’s commitment to fighting fraud at every turn to restore public trust in our institutions. We will work tirelessly to hold corrupt medical professionals accountable and recover stolen taxpayer dollars for the American people.”
Prosecutors said Wilson attempted to conceal the scheme by using shell accounts and nominee owners, including having a member of her church open a bank account for one of the telemedicine companies. Authorities also said Wilson and her husband, Reinaldo Wilson, who was previously sentenced to seven years in prison, used proceeds from the fraud to purchase luxury vehicles, including multiple Rolls-Royces.
After her arrest, prosecutors said Wilson marketed herself as a “Medical Professional Legal Consultant” and authored books on health care compliance, including one titled Avoiding Health Care Pitfalls.
The Justice Department said the fraudulent scheme resulted in more than $136 million in false Medicare billings, with Medicare paying more than $66 million before the fraud was uncovered.
Key Points
- A Georgia nurse practitioner was sentenced to 10 years in prison for a $136 million Medicare fraud scheme.
- Prosecutors said the operation generated more than $66 million in Medicare payments for medically unnecessary braces and prescription drugs.
- Wilson was ordered to pay $66 million in restitution, and her husband previously received a seven-year prison sentence for his role.
