Healthcare claims administrator co-owner pleads guilty in $40M fraud scheme

The co-owner of a Connecticut-based insurance firm pleaded guilty to his role in a $40 million scheme to steal client healthcare funds and defraud lenders, the Justice Department said. 

Anthony Riccardi, 46, was the co-owner and executive vice president of Employee Benefit Solutions, which offered healthcare services to clients, according to a Feb. 21 Justice Department news release. Among those services was third-party healthcare claims administration for clients that elected to self-fund their employee healthcare plan. 

Mr. Riccardi and his co-conspirators allegedly used false and inflated invoices to steal client healthcare funds, according to the release. They also received millions of dollars in loans, claiming to use the funds to purchase upgraded billing software. Mr. Riccardi and his co-conspirators allegedly submitted fabricated invoices from a fake company that supposedly sold the software.  

Mr. Riccardi pleaded guilty to one count of conspiring to commit wire fraud and bank fraud, which carries a maximum of 30 years in prison, according to the release. As part of his plea, he agreed to pay $14.87 million in restitution and forfeit $2 million. He is scheduled to be sentenced July 20. 

His co-defendant Patricia Riccardi previously pleaded guilty to one count of conspiring to commit wire fraud and bank fraud and is scheduled to be sentenced June 20, according to the release. Another co-defendant, Erin Verespy, the CFO of Employee Benefit Solutions, was sentenced to 66 months in prison in March. 

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