MM Curator summary:
A surgeon and his office manager billed Medicare and Medicaid for more than 3,000 surgeries that never happened. In the process they stole $23M.
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Kimberly Austin changed her plea in a hearing on the afternoon of Nov. 13.(WCTV)
TALLAHASSEE, Fla. (WCTV) – The office manager of Dr. Moses deGraft-Johnson plead guilty to one count of conspiracy to commit healthcare fraud on Friday. Kimberly Austin changed her plea in a hearing on the afternoon of Nov. 13.
Austin and deGraft-Johnson were indicted in February; the 58 count indictment alleges that they defrauded Medicare and Medicaid, billing for surgeries that were never performed. Prosecutors say the improper billing hit $23 million; they said in 3,600 surgeries billed over five years, 85 to 90% never happened.
Prosecutors also say the surgery deGraft-Johnson claimed to perform is “relatively rare,” and that he did not have enough of the devices required to do the surgeries.
The two worked at the Heart and Vascular Institute of North Florida.
The change of plea hearing for Austin lasted about 45 minutes, with the Judge checking that her guilty plea was not coerced and ensuring it is “voluntary and factual.”
Austin faces up to 10 years in prison for the conspiracy charge.
During her testimony, she said she was born, raised, and has always lived in Sneads, Florida.
She was visibly shaken during the testimony in front of Judge Mark Walker.
“It’s readily apparent to me that you’re upset, that you’re remorseful,” said Judge Walker. “I can tell this is a big deal to you.”
The Judge went over three documents during the hearing: a plea agreement, a supplemental plea agreement, and a statement of facts. He explained that it is up to the prosecutors to file a substantial assistance motion, depending on her testimony.
The statement of facts was 59 pages; Judge Walker cross-checked certain aspects with Austin.
“He used your assistance to pull of his scheme, correct?” he asked.
“Yes, sir,” said Austin.
“You admit you helped him commit healthcare fraud?”
“Yes, sir,” said Austin.
Austin testified that she covered for the doctor when patients called and complained, and said she knew he was billing for procedures that took place when he was out of the office.
She is out of custody under the conditions previously set by the magistrate judge. Austin’s sentencing is set for 2:30 p.m. on March 18; deGraft-Johnson’s trial is set for Jan. 25.
Clipped from: https://www.wctv.tv/2020/12/14/office-manager-of-doctor-indicted-for-23-million-in-healthcare-fraud-pleads-guilty/