HOUSTON – Tiffany Nicole Thompson, 31, has been convicted of conspiracy to commit health care fraud and four counts of health care fraud in relation to nearly $4 million in fraudulent health care claims, announced United States Attorney Kenneth Magidson and Janice M. Flores, special agent in charge of the Defense Criminal Investigative Service (DCIS), Southwest Field Office.
“The plea in this matter is the result of a highly successful investigative effort by the DCIS and the U.S. Attorney’s Office,” said Flores. “As the investigative arm of the Department of Defense – Office of Inspector General, one of our primary missions is the detection of fraud, especially the type that targets critical funding for health care for our warfighters, their families and military retirees. This plea serves as a warning for those intent on committing this type of criminal activity that law enforcement will pursue these crimes relentlessly.”
At the hearing today, Thompson admitted she worked as the office manager and biller for Rabon Communication Enhancement (RCE), a speech therapy clinic in Sugarland that provided speech therapy to children.
Thompson admitted she conspired to submit $3,784,642 in false and fraudulent claims to Tricare and Blue Cross and Blue Shield of Texas for speech therapy and swallowing therapy treatments that were not provided. Thompson admitted she knowingly billed Tricare for services when children did not appear for appointments. Thompson further admitted she billed Blue Cross and Blue Shield for approximately $545,440 worth of services for herself and another person, neither of whom were patients at RCE or received any health care services at RCE. She also submitted more than $379,000 in false and fraudulent claims to Blue Cross and Blue Shield for three fellow employees who worked at the clinic and never received any treatment there. Thompson further admitted that a letter with a forged signature was sent to Blue Cross and Blue Shield directing them to send one of the employees benefit statements to alternative address not that of the employee.
The two insurance companies paid at least $1,285,827.67 for the claims Thompson submitted.
U.S. District Judge Melinda Harmon accepted the plea today and has set sentencing for Oct. 24, 2014. At that time, Thompson faces up to 10 years in federal prison on each count as well as a possible $250,000 fine. She was permitted to remain on bond pending that hearing.
Assistant United States Attorney Julie Redlinger is prosecuting the case.