Overbilling

July 25, 2008 permalink

Social worker Rhonn Gilchrist, is in trouble for billing two insurance companies for the same service. Social workers should stick to double billing parents and governments, where they can get away with it.

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Tuesday, July 22, 2008 - 2:39 PM EDT

Social worker sentenced to year in prison

Business First of Buffalo - by Jodi Sokolowski Business First

A licensed social worker who was convicted of health-care fraud on Feb. 20 has been sentenced to 12 months in jail and fined $3,000.

Rhonn Gilchrist, 59, was convicted of defrauding health care insurance companies resulting from his submission of fraudulent claim forms seeking payments for treatment he never provided to patients, according to Assistant U.S. Attorney John Rogowski, who handled the case. Gilchrist, who had an office on Niagara Falls Boulevard in Tonawanda, conducted the fraud from 2002 to 2007. Sentencing took place before U.S. District Court for the Western District of New York Judge William Skretny.

Gilchrist, whose patients included individuals covered under the New York Workers' Compensation Program or the New York state no-fault automobile insurance law, engaged in a practice known as double billing, which is billing two insurance companies for the full amount of a treatment provided to the individual.

While a health care provider may bill two insurance companies for the same treatment, the provider must disclose that fact and repay any amount received over 100 percent of the cost of the service. The defendant did not disclose the double billing and kept the over-payments of $102,000.

Skretny ordered him to make restitution to the various insurance companies. Gilchrist agreed to a criminal forfeiture of $90,000 in cash and a condominium in Sarasota, Fla., valued at about $400,000, which he purchased, in part, using the illegal proceeds.

The investigation was conducted by the Western New York Health Care Fraud Task Force consisting of agents from the FBI, U.S. Postal Service, Department of Health and Human Services, Department of Defense, the FDA, the Department of Labor and the New York State Insurance Fraud Bureau.

Source: Buffalo Business First