The owner of a medical billing company and a Detroit-area physician have been sentenced to prison for their roles in a $26 million fraud scheme that involved billing Medicare for nerve block injections that were never provided, according to the Department of Justice.
According to evidence presented at trial, Johnny Trotter, MD, and Elaine Lovett, the owner of an Oak Park, Mich.-based medical billing company called ABIX, knowingly submitted fraudulent claims to Medicare between May 2008 and May 2014 for services they knew had not been provided. Most of the fraudulent bills were for nerve block injections.
Evidence at trial also showed that after Medicare imposed a requirement in 2009 that Dr. Trotter's claims undergo a medical review prior to payment, he and Ms. Lovett created sham medical practices to circumvent Medicare's fraud investigation. To conceal their involvement, they allegedly had family members and employees serve as straw owners of the companies, according to the DOJ.
After a four-week trial, Dr. Trotter and Ms. Lovett were each convicted in April 2017 of three counts of healthcare fraud and one count of conspiracy to commit healthcare fraud and wire fraud.
Ms. Lovett was sentenced Sept. 26 to 10 years in prison, and Dr. Trotter was sentenced Tuesday to 15 years in prison.
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