Two Charlotte-area women face prison terms and must pay back hundreds of thousands of dollars after being sentenced for their roles in a major Medicare and Medicaid fraud scheme, federal prosecutors say.
Karen Wills, 43, of Salisbury, was sentenced last week to eight years and one month in prison and was ordered to pay $786,316 in restitution to Medicaid, Medicare and Medco Health Solutions. Her co-defendant, 40-year-old Wendy Gibson of Charlotte, was sentenced to four years in prison and must pay $358,330 in restitution.
The two entered guilty pleas in January to charges of health care fraud conspiracy, paying and receiving illegal kickbacks, and conspiring to distribute controlled substances. Wills also pleaded guilty to an additional count of health care fraud conspiracy.
According to court documents, Wills, Gibson and others participated in a scheme in 2008 and 2009 that involved power wheelchairs.
Prosecutors said Wills used her position with her employers company to submit fictitious referrals for patients to receive power wheelchairs from the company that Gibson worked for. In some cases, prosecutors said, Wills forged a physicians signature on referrals. Authorities said Gibson then tracked and directed the payments.
According to the government, the scheme resulted in payments for unneeded wheelchairs that totaled more than $300,000.
The two also were accused of conspiring to forge a physicians signature on prescription pads for oxycodone and hydrocodone. Prosecutors say Gibson admitted using her health insurance prescription benefit program to pay for the drugs, at a cost of more than $30,000. The government said the two women obtained and illegally distributed about 8,000 pills.
Prosecutors say Wills was involved in another scheme from 2008 to January 2011, which involved fraudulent claims for medical tests. The government said Medicare and Medicaid paid more than $400,000 in reimbursements for those claims.
Authorities say Wills and others became aware of an investigation into the scheme in August 2008 and tried to cover up the activities by creating false test reports and putting them in patients files.
Prosecutors say Wills has been in federal custody since August 2011. Gibson is free on bond, but will be ordered to report to a federal prison.
The federal charges against Wills came a short time after Rowan County sheriffs deputies in August 2011 raided the home where she and her husband, Anthony Quinn Jackson, lived.
Authorities say they confiscated 64 marijuana plants, 16 firearms and 8 pounds of packaged marijuana.