威斯康星州成人家庭之家经营者医保诈骗判监28个月：为从未提供的护理工时收费盗取逾125万美元
美国司法部威斯康星东区联邦检察官办公室10月28日宣布，现年49岁、曾经营成人家庭之家的Lori Butts因医疗保健诈骗被判处监禁28个月。她从一个由联邦医疗补助（Medicaid）资助、为威斯康星州残疾居民提供住宿护理服务的项目中盗取了1,253,920.47美元。
Butts此前经营Lordan Care Adult Family Homes公司，为Medicaid受益人提供住宿服务。这类服务由政府逐名受益人授权，参加项目的居民住在多卧室公寓里，由护理员提供24小时看护，部分居民还额外享有一对一专人护理。
Butts承认，2019年7月至2020年12月间，她为从未提供的护理工时开具账单收费。
其中包括为两名护理员向单一住户提供全天24小时专职服务收费，而这些护理员当时根本不在岗。检方指出，她的成人家庭之家长期人手严重不足，还频繁有警察上门，原因往往是值班人员不足、无法处置住户的失控或不当行为。
联邦地区法官J.P. Stadtmueller在宣判时强调这一行为性质「令人发指」，指出纳税人被蒙骗：他们为数万小时从未提供的护理时间付了钱，这种为未做的工时开账单、收下机构款项的行为「在功能上等同于重大盗窃」。法官还表示，这一有分量的刑期旨在震慑其他企图诈骗政府医疗保健项目的人。
除28个月监禁外，Stadtmueller法官还判令Butts向Medicaid赔付1,253,920.47美元。
威斯康星东区代任联邦检察官Brad D. Schimel说：「被告窃取这笔钱，是从每一位美国纳税人手中夺走，并从需要帮助的人那里挪走。」联邦调查局（FBI）Milwaukee办公室主管特工Alan Karr表示，Butts为从未向威斯康星残疾成年人提供的服务开账单，FBI将继续追究诈骗政府牟利者。国税局刑事调查局（IRS-CI）Chicago外地办公室代任主管特工Robert J. Kuszynski也表示，她把「为一个人的护理承诺」变成了自己的「发薪日」，刑期正是这一选择的代价。
此案由联邦调查局（FBI）与国税局刑事调查局（IRS-CI）调查，助理联邦检察官Carter B. Stewart与Zachary J. Corey负责起诉。
Wisconsin Adult Family Home Operator Sentenced to 28 Months for Healthcare Fraud: Billed for Care Never Provided, Stole More Than $1.25 Million From Medicaid
The U.S. Attorney's Office for the Eastern District of Wisconsin announced on October 28 that Lori Butts, 49, the former operator of adult family homes, was sentenced to 28 months in prison for a healthcare fraud scheme through which she stole $1,253,920.47 from a Medicaid-funded program designed to provide residential care services for disabled Wisconsin residents.
Butts previously operated Lordan Care Adult Family Homes, a company that provided residential services to Medicaid beneficiaries. The government authorizes these services on a beneficiary-by-beneficiary basis. All residents in the program are placed in a multi-bedroom apartment that has 24-hour supervision by a caregiver, and some residents also receive one-on-one care from a worker in addition to this caregiver.
Butts admitted that from July 2019 to December 2020, she billed for hours of care work never provided.
In particular, she billed for two workers to provide dedicated service, 24 hours per day, to a single resident, but those caregivers were not present. Prosecutors said her adult family homes were severely understaffed and experienced frequent police contact, often when staffing levels were insufficient to address volatile or inappropriate resident conduct.
In announcing the sentence, United States District Judge J.P. Stadtmueller emphasized the "reprehensible" nature of the conduct. He noted that "the taxpayers were bilked" because they paid for tens of thousands of hours of caregiver time that Butts's company simply did not provide, and that billing for unworked hours while accepting the agency's money was the "functional equivalent of grand larceny." The judge also explained that the significant sentence was necessary to send a message of deterrence to others considering fraud against government healthcare programs.
In addition to the 28-month prison sentence, Judge Stadtmueller ordered Butts to pay restitution to Medicaid of $1,253,920.47.
"When the defendant stole this money, she took it from every American taxpayer and diverted it from individuals who needed help," said First Assistant U.S. Attorney Brad D. Schimel. Alan Karr, Special Agent in Charge of the FBI's Milwaukee office, said Butts billed for services never provided to disabled Wisconsin adults and that the FBI remains committed to holding accountable individuals who defraud the government. Robert J. Kuszynski, Acting Special Agent in Charge of IRS Criminal Investigation's Chicago Field Office, said Butts turned a promise to care for someone into a payday, and that her prison sentence is the price of that choice.
The case was investigated by the Federal Bureau of Investigation and IRS Criminal Investigation, and prosecuted by Assistant United States Attorneys Carter B. Stewart and Zachary J. Corey.
来源：GSM·美国（原文链接）
图片来源：图：美国联邦调查局（FBI）总部胡佛大楼。本案由FBI参与调查。ajay_suresh摄，CC BY 2.0，经Wikimedia Commons。 / The J. Edgar Hoover Building, headquarters of the FBI, which investigated this case. Photo by ajay_suresh, CC BY 2.0, via Wikimedia Commons.
