A Florida businesswoman has agreed to settle criminal and civil charges from an alleged scheme involving the submission of more than $400 million in false claims to Medicare and the Civilian Health and Medical Program of the VA, the U.S. Justice Department said.
Kelly Wolfe pleaded guilty to conspiracy to commit healthcare fraud and filing a false tax return. The guilty plea involves criminal allegations. She faces up to 13 years in federal prison.
Ms. Wolfe and her company, Regency, also agreed to pay a civil settlement of $20.3 million to resolve allegations they violated the False Claims Act. The civil settlement arose from a lawsuit brought under the whistleblower provisions of the False Claims Act by Condra Albright, a former Regency employee.
Prosecutors said that other than the conduct admitted in connection with Ms. Wolfe's criminal guilty plea, the claims resolved by the civil settlement are allegations only.
According to prosecutors, Ms. Wolfe and her conspirators used Regency to establish durable medical equipment companies in the names of straw owners. By concealing true ownership, Ms. Wolfe and her conspirators secretly gained control of the companies and submitted more than $400 million in illegal durable medical equipment claims to insurers.
Ms. Wolfe admitted to filing a false tax return in 2017. Prosecutors said she purchased personal items using Regency's funds and falsely classified the spending as business expenditures.