EAST ST. LOUIS - A Glen Carbon woman - Jami L. Mayhew - entered a guilty plea today to a single-count felony information charging her with healthcare fraud in federal court in East St. Louis.
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Facts elicited at the plea hearing established that, from May 30 to June 26, 2017, the 41-year old nurse practitioner knowingly participated in a scheme to defraud Medicare by performing medically unnecessary visits in nursing homes located in St. Clair and Madison counties. Mayhew carried out the fraudulent scheme by seeing nursing home residents multiple times, examining them for only a few minutes at a time, generating progress notes she knew contained misrepresentations and materially false statements about the services she had performed, and falsely reporting that her visits met the billing requirements for complex subsequent nursing home encounters, when in fact they had not.
As part of her guilty plea, Mayhew admitted that she knowingly caused 251 false claims to be submitted to Medicare during the charged timeframe. Medicare paid her employer, General Medicine, P.C., over $23,000 for those visits.
Mayhew, herself, received $27 from the company for each of the false claims she caused to be submitted, for a total of $6,777. Sentencing is scheduled for Dec. 10, 2020.
Healthcare fraud is a felony punishable by up to 10 years in prison and a $250,000 fine.
Members of the public who believe they may have information related to this or any similar schemes involving healthcare fraud in nursing homes are encouraged to contact law enforcement by calling the HHS fraud hotline at 1-800-HHS-TIPS (1- 800-447-8477) or by going online at https://oig.hhs.gov/fraud/report-fraud/.
The investigation of this case was a collaborative effort conducted by the Department of Health and Human Services – Office of Inspector General, the Illinois State Police Medicaid Fraud Control Bureau, the Department of Labor – Office of Inspector General, the Department of Labor – Employee Benefits and Security Administration, the Federal Bureau of Investigation, the United States Postal Inspection Service, and the Defense Criminal Investigative Service. The case is being prosecuted by Assistant U.S. Attorney Nathan D. Stump.
