Author of book on healthcare fraud sentenced in Medicare scheme
EXCLUSIVE — The author of multiple books on healthcare compliance was sentenced Tuesday to federal prison for fraudulently billing Medicare as part of a $136 million scheme that spanned several U.S. states, the Washington Examiner has learned.
Jean Wilson, 54, received a 10-year prison sentence, followed by three years of supervised release, in the U.S. District Court for the District of New Jersey for her role in the medical billing scam involving illegal kickbacks and massive quantities of phony prescriptions.
According to the superseding indictment, Wilson owned and operated two telehealth companies that paid medical providers to place bulk orders of orthotic devices and prescription drugs for Medicare patients who did not need the braces or medication. Prosecutors said Wilson, a licensed nurse, signed many of the prescriptions herself.
After acquiring the supply orders and forged drug prescriptions, Wilson and other co-conspirators sold them off to purported marketing companies for an average of $90 per Medicare beneficiary. Those predatory marketing agencies then resold the signed orders to brace suppliers and pharmacies and pressured patients into accepting as many braces as possible.
Evidence entered in the case showed that bribed medical practitioners working for Wilson signed orders for four or more orthotic braces per beneficiary in more than 3,000 patient files. In fact, over 40 beneficiaries each received orders for 10 or more devices.
Over the course of only two years, Wilson and her accomplices submitted fraudulent claims to Medicare totaling more than $136 million, of which Medicare paid out over $66 million.
Her husband, Reinaldo Wilson, was sentenced in February to seven years behind bars for his involvement in the conspiracy. Court documents say that the couple used the scheme’s proceeds to purchase luxury vehicles, including several Rolls-Royces.
Wilson was also ordered on Tuesday to pay $66 million in restitution and forfeit $7.8 million. She previously pleaded guilty to conspiring to commit wire fraud and healthcare fraud.
“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,” McDonald told the Washington Examiner. “We will work tirelessly to hold corrupt medical professionals accountable and recover stolen taxpayer dollars for the American people.”
Wilson, a self-described “medical professional legal consultant” and “compliance expert,” has written several books on healthcare fraud. In her book Avoiding Health Care Pitfalls, which is still available to buy on Amazon, Wilson wrote, “Some entities and individuals will try to use you as a way to make them millions!” Wilson marketed the book as the compliance resource “every healthcare provider should have,” telling readers, “Your license will thank you!”