Former Plainview Health Care Clinic CEO Pleads Guilty to Fraud - KCBD NewsChannel 11 Lubbock

12/4/07

Former Plainview Health Care Clinic CEO Pleads Guilty to Fraud

The former Chief Executive Officer of Oasis Medical Clinic in Plainview, Texas, Angela Michelle Edwards, pled guilty on Thursday in federal court to an information charging one count of health care fraud, announced U.S. Attorney Richard B. Roper of the Northern District of Texas.  Edwards, 37, entered her plea before U.S. District Judge Sam R. Cummings, who ordered a pre-sentence investigation with sentencing to be scheduled after that investigation is completed.  Edwards faces a maximum statutory sentence of 10 years in prison, a $250,000 fine and restitution. 

Edwards admitted that from January 2002 through August 2005, she caused "up-coded" and improperly coded claims and diagnosis codes to be submitted to Medicaid, Medicare and private insurance companies in order to receive higher payments than those authorized by the payors.  Even though she knew that only clinicians were authorized to make diagnoses and determine the level of a patient visit for payment purposes, Edwards personally changed bills submitted by the clinicians and taught her billing staff to routinely change bills by submitting claims for visits that were marked at higher levels than the ones indicated by the clinician and by adding patient diagnoses and procedures to the claims before they were submitted to the payors.

Edwards admitted that she is personally responsible for the restitution in this case because:  she caused Oasis to be overpaid; she caused poor banking and accounting records to be kept; she unlawfully took money f rom Oasis' accounts for personal expenses during her tenure as CEO; and Oasis is now in bankruptcy.

As a result of her actions, health care payors, including Medicare, Medicaid, Children's Health Insurance Program and commercial insurance companies, paid Oasis $370,657 for fraudulent billings.

U.S. Attorney Roper praised the excellent investigative work of Texas Attorney General Greg Abbott's Office - Medicaid Fraud Unit and the Federal Bureau of Investigation (FBI).  The case is being prosecuted by Special Assistant U.S. Attorney Amy R. Burch of  the Texas Attorney General's Office.

Source: United States Attorney Richard B. Roper, Northern District of Texas

Courts & Crime
Take a look at the Courts & Crime news from around Lubbock.

  • Local News on KCBD.comNewsMore>>

  • After years of dejection, proponents of gun laws see hope

    After years of dejection, proponents of gun laws see hope

    Saturday, February 24 2018 10:35 AM EST2018-02-24 15:35:23 GMT
    Saturday, February 24 2018 3:18 PM EST2018-02-24 20:18:03 GMT
    The progression has become numbingly repetitive - mass bloodshed unleashed by a gunman, followed by the stories of the fallen, the funerals and mourning. (Source: AP Photos)The progression has become numbingly repetitive - mass bloodshed unleashed by a gunman, followed by the stories of the fallen, the funerals and mourning. (Source: AP Photos)

    "Our kids have started a revolution:" Teens' activism after Florida school shooting has some hopeful for action on gun policy.

    "Our kids have started a revolution:" Teens' activism after Florida school shooting has some hopeful for action on gun policy.

  • GOP tax law leads to a tax hike, more revenue in some states

    GOP tax law leads to a tax hike, more revenue in some states

    Saturday, February 24 2018 10:15 AM EST2018-02-24 15:15:40 GMT
    Saturday, February 24 2018 3:17 PM EST2018-02-24 20:17:47 GMT
    (AP Photo/Melinda Deslatte, File). FILE- In this Feb. 19, 2018, file photo, Rep. Jean-Paul Coussan, R-Lafayette, left, speaks with Rep. Tanner Magee, R-Houma, on the opening day of the special legislative session in Baton Rouge, La. A tax overhaul is g...(AP Photo/Melinda Deslatte, File). FILE- In this Feb. 19, 2018, file photo, Rep. Jean-Paul Coussan, R-Lafayette, left, speaks with Rep. Tanner Magee, R-Houma, on the opening day of the special legislative session in Baton Rouge, La. A tax overhaul is g...
    The Republican tax overhaul is bringing most Americans lower income taxes but also is causing some state income taxes to rise, leading to extra revenue for state budgets.
    The Republican tax overhaul is bringing most Americans lower income taxes but also is causing some state income taxes to rise, leading to extra revenue for state budgets.
  • NRA, Florida faces backlash after latest school shooting

    NRA, Florida faces backlash after latest school shooting

    Saturday, February 24 2018 4:36 AM EST2018-02-24 09:36:41 GMT
    Saturday, February 24 2018 3:17 PM EST2018-02-24 20:17:36 GMT
    (AP Photo/Mark Lennihan, File). FILE- In this Feb. 15, 2006, file photo, BlackRock headquarters is shown in New York. U.S. companies are taking a closer look at investments, co-branding deals and other ties to the gun industry and its public face, the ...(AP Photo/Mark Lennihan, File). FILE- In this Feb. 15, 2006, file photo, BlackRock headquarters is shown in New York. U.S. companies are taking a closer look at investments, co-branding deals and other ties to the gun industry and its public face, the ...

    NRA faces corporate backlash after latest school shooting.

    NRA faces corporate backlash after latest school shooting.

Powered by Frankly