Doctor pleads guilty to fraud

A Jacksonville doctor pleaded guilty Thursday in federal court to bilking $400,000 out of the government in Medicare fraud.

Janet Johnson-Hunter, 50, admitted to conspiring to conceal material facts in connection with the delivery of and payment for health care benefits, items, and services.

Johnson-Hunter changed medical records and ordered employees to change records to indicate patients’ needs to ride in an ambulance, when they did not, in order to be reimbursed by Medicare or Medicaid, according to a federal criminal information complaint was filed Nov. 30.

The programs only cover non-emergent transportation by ambulance in rare occasions. If a patient is able to walk or ride in a wheelchair, the government does not pay for ambulatory transportation.

However, from January 2002 to August 2005, Johnson-Hunter, a licensed medical doctor and former owner and manager of a private ambulance transportation company in Jacksonville, instructed her employees to change medical files to maximize the likelihood of reimbursement from Medicare and Medicaid for ambulance transports.

Agents with the N.C. Department of Health and Human Services Office of the Inspector General and the N.C. Department of Justice Medicaid Investigations Unit interviewed several emergency medical technicians and billing staff who worked for Johnson-Hunter. Each one gave statements that either directly or through subordinates, Johnson-Hunter directed employees to change medical records that stated patients could sit upright, stand, walk or ride in a wheelchair, according to federal authorities.

“This guilty plea is an important step in our ongoing battle against medical care and government program fraud,” said George E.B. Holding, the U.S. Attorney for the Eastern District of North Carolina. “The abuse and misuse of the Medicare and Medicaid Programs impacts each of us as taxpayers and citizens and these prosecutions are critical to protect these programs.”

Johnson-Hunter faces a possible prison sentence of five years and three years supervised parole. She could also be ordered to pay a fine of up to $250,000 when she is sentenced early next year, Holden said.

Contact Lindell Kay at 910-219-8456. Read his blog here.