A New York identity thief who stole the medical information of almost 1000 patients and committed $10.7 million in Medicare fraud has been found guilty of HIPAA violations by a New York federal court and given a 12-year sentence in a federal penitentiary.
Over a four-year duration, Helene Michel, the owner of Hicksville NY., Medical Solutions Management Inc. (MSM), impersonated a doctor – using the name Dr. Elene Allonce – as well as nurses, wound care specialists and other healthcare professionals to gain access to Social Security numbers and medical data of patients in order to make fraudulent medical claims to finance her extravagant lifestyle.
Michel was able to access to nursing centers in Nassau, Suffolk, Queens, Kings and Dutchess Counties between April 2003 and March 2007. She was able to obtain the information she needed to make false Medicare claims for services provided by her company. The proceeds from her crimes were used to buy a $2.2 million Old Brookville home, establish a personal pension plan as well as an investment brokerage account, thought to be worth $2 million.
The crimes she committed potentially stopped patients from receiving medical care they needed, although in once instance she managed to obtain reimbursement for prescription boots and leg braces that her company supplied to an elderly double above-the-knee amputee; according to a report on PHIPrivacy.net.
Michel was charged in March 2012 with conspiracy and health care fraud and was one of the first people to be charged with violations of the Health Insurance Portability and Accountability Act for the wrongful disclosure of Protected Health Information. This case is one of just a number that lead to a criminal conviction for HIPAA violations.
At the trial, 15 boxes of patient files holding mostly original copies of medical information were used as evidence according to Loretta E. Lynch, U.S. Attorney for Eastern District of New York. She stated “Through her scheme she violated the privacy of over a thousand patients and stole Medicare funds dedicated to preserving the health of our seniors and other citizens.”
Michel possibly faced a jail term of up to 10 years per count, although she will only have to serve 12 years instead of the maximum term of 30 years for the three counts. She could also have been fined up to $250,000 for each count, although she has lost the $1.3 million that the government seized from her when she was found guilty. Etienne Allonce was also indicted along with Michel, although he is still a fugitive and is currently listed on HHS-OIG’s Most Wanted List.
Medicare and Medicaid fraud can lead to patients being denied services and treatments they require and/or being given incorrect treatments, both of which potentially have life threatening results. This case emphasizes the importance of checking Explanation of Benefits statements. Any fraudulent activity must be discovered promptly to ensure any damage can be prevented.