BI’s Article search uses Boolean search capabilities. If you are not familiar with these principles, here are some quick tips.
To search specifically for more than one word, put the search term in quotation marks. For example, “workers compensation”. This will limit your search to that combination of words.
To search for a combination of terms, use quotations and the & symbol. For example, “hurricane” & “loss”.
A federal appeals court on Monday affirmed the convictions of two individuals involved in fraudulent Houston-based chain of clinics that claimed to provide rehabilitation services for hundreds of injured federal workers in several states but was found to fabricate bills for seeing patients who were never treated, among other charges.
Pamela Rose and Frankie Sanders, sentenced in 2017 to 10 years and 25 years, respectively, were executives at Federal Work Ready, a business that collected most of its revenue from the federal workers compensation program, receiving “millions of dollars in reimbursements,” according to documents in United States of America v. Frankie Lee Sanders; Pamela Annette Rose, filed in the 5th U.S. Circuit Court of Appeals in New Orleans.
A jury convicted the pair, along with Ms. Rose’s husband Jeffrey Rose, the organization’s CEO not named in the appeal, of conspiracy and fraud for participating in the plot to “defraud the federal workers' compensation fund.” Mr. Rose in 2018 was sentenced to more than 19 years in prison and ordered to repay nearly $15 million.
On appeal, both Ms. Rose and Mr. Sanders challenged the “sufficiency of the evidence,” among other issues that included a protest of the criminal forfeiture of several properties gained as a result of the fraudulent business, according to documents.
The appeals court affirmed the 2017 convictions, writing that there was “ample” evidence of wrongdoing. “(Ms.) Rose also urges that there was no evidence that she was party to an illicit agreement with her husband to launder money. But again, plenty of evidence suggests otherwise,” the latest ruling states, adding that evidence exists that properties obtained by Ms. Rose were connected to the money gained from the fraud.
Efforts to identify and prosecute provider fraud in the California workers compensation system is likely having an impact in both reducing such payments and lowering their associated costs, according to a new report.