West Virginia
News Archive: 2009 Quick Reference: July 23, 2010 - Martinsburg Physician Indicted for Health Care Fraud – Read More May 18, 2010 - Woman Sentenced for Health Care Fraud – Read More |  |
Martinsburg Physician Indicted for Health Care Fraud (U.S. Attorney for the Northern District of West Virginia)
Martinsburg, West Virginia - A 54 year old Martinsburg physician was named in an Indictment returned by a Federal Grand Jury sitting in Martinsburg, West Virginia.
United States Attorney Betsy C. Jividen announced that Danine A. Rydland, MD, was named in a 38-count Indictment charging her with health care fraud. From June 1, 2004, to September 5, 2008, Rydland owned and operated a medical practice located in Falling Waters, Berkeley County, West Virginia; where she was assisted in the day-to-day operation of her medical practice, including the preparation of claims for reimbursement and submission of same to Medicare, West Virginia Medicaid, the Public Employee Insurance Agency, Unicare, and other third party payers.
Counts One through Fourteen of the Indictment allege that Rydland devised a scheme to defraud health care benefit programs, namely, Medicare, Medicaid, PEIA, and Unicare, and to obtain money owned by and under the custody of said health care benefit programs by means of false and fraudulent pretenses from June 2004 and continuing to September 2008. It was part of the scheme that Rydland fraudulently obtained approximately $22,000 from Medicare; $59,000 from Medicaid; $3,400 from Unicare; and $2,800 from PEIA as a result of claims for prolonged services that were not rendered and for which there was no documentation of the amount of time spent in face-to-face contact with the patients.
Counts Fifteen through Twenty-Six of the Indictment allege that Rydland devised a scheme to defraud health care benefit programs, namely, Medicare, Medicaid, PEIA, and Unicare, and to obtain money owned by and under the custody of said health care benefit programs by means of false and fraudulent pretenses from June 2004 and continuing to September 2008. It was part of the scheme that Rydland fraudulently obtained approximately $22,000 from Medicare; $22,000 from Medicaid; $5,000 from Unicare; and $7,500 from PEIA as a result of claims which misrepresented a higher level of office visit or for which no such service was rendered at all.
Counts Twenty-Seven through Thirty-eight of the Indictment allege that Rydland devised a scheme to defraud health care benefit programs, namely, Medicare, Medicaid, PEIA, and Unicare, and to obtain money owned by and under the custody of said health care benefit programs by means of false and fraudulent pretenses from June 2004 and continuing to September 2008. It was part of the scheme that Rydland willfully accepted payment from Medicare, Medicaid, Unicare, and PEIA for established patient office visit services that were not rendered.
If convicted, Rydland faces a maximum penalty of 10 years imprisonment and a fine of $250,000 on each count of the Indictment.
The case will be prosecuted by Assistant United States Attorneys Erin K. Reisenweber and Alan G. McGonigal. The case was investigated by the United States Department of Health and Human Services - Office of Inspector General and West Virginia Medicaid Fraud Control Unit.
It should be noted that the charges contained in the Indictment are merely accusations and not evidence of guilt, and that each defendant is presumed innocent until and unless proven guilty.
Woman Sentenced for Health Care Fraud (U.S. Attorney for the District of West Virginia)
Vanessa Cattanea, 36, of Charleston, West Virginia, was sentenced yesterday to 20 months in federal prison for multiple counts of health care fraud, the United States Attorney’s Office announced on May 18, 2010. Chief U.S. District Judge B. Lynn Winmill also ordered Cattanea to serve three years of supervised release following her prison term, and required her to pay $1,054,260 in restitution to Medicaid. Co-defendant, Ronald Bret Hamilton, 49, of Pocatello, passed away in March 2010.
Cattanea and Hamilton were convicted in December 2009 by a federal jury in Pocatello, Idaho, on multiple counts of health care fraud. The jury found Hamilton guilty on 55 of 72 counts and Cattanea guilty on 76 of 84 counts.
During the nine-day trial, the jury heard evidence that Hamilton was the owner and Cattanea the treatment director for Teton Family Services, a company that offered partial care, a mental health service, for children. Teton operated clinics in Pocatello, Blackfoot and American Falls. The evidence showed that Hamilton and Cattanea knowingly and fraudulently billed Medicaid for services provided away from the clinic, which Medicaid does not cover, including trips to Yellowstone National Park, Bear Lake, and Salt Lake City, and for services provided by unlicensed staff.
“The costs of health care in this country are huge. Everyone is concerned and angry when public efforts to provide needed health care is defrauded and profiteered by unscrupulous people,” said U.S. Attorney Tom Moss.
This case was jointly investigated by the U.S. Department of Health and Human Services, Office of Inspector General, and Idaho Department of Health and Welfare.
