DETROIT – Millicent Traylor, 47, was sentenced to 135 months in prison Thursday for her role in a scheme involving approximately $8.9 million in fraudulent Medicare claims.
According to authorities, the fraudulent claims were for home health care and other physician services that were procured through the payment of kickbacks, were not medically necessary or were not actually provided.
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Following a four-day trial, Traylor was convicted in May of one count of conspiracy to commit health care fraud, one count of conspiracy to pay and receive health care kickbacks, and five counts of health care fraud.
According to evidence presented at trial, from 2011 to 2016, Traylor and her co-conspirators engaged in a scheme to defraud Medicare of approximately $8.9 million through fraudulent home health and physician claims. The evidence showed Traylor, who was unlicensed at the time, acted as a physician for these companies, providing services that were not medically necessary and that were billed to Medicare as if they were provided by a licensed physician.
The evidence further showed that Traylor conspired to cause Medicare to be billed for services that were not rendered. To make it appear that these services were medically necessary and actually provided, Traylor and her co-conspirators falsified medical records and signed false documents.
Additionally, the evidence at trial showed that Traylor and her co-conspirators paid and received kickbacks in exchange for referring Medicare beneficiaries to serve as patients at the clinics and Traylor fraudulently signed the names of licensed physicians on prescriptions for opioid medications, such as oxycodone, as a means of inducing patient participation in the scheme.