DES MOINES, IA – On March 29, 2012, Angela Shae Ellison, age 45, of Centerville, Iowa, made her initial appearance in federal court on charges of committing over $700,000 of fraud against Medicaid, WellMark Blue Cross/Blue Shield, Aetna, and United Health through false billing, announced U.S. Attorney Nick Klinefeldt.
Counts one through four of the federal indictment charge that Ellison, between February 2007 and March 2010, submitted false claims for payment to Medicaid and three insurance companies to obtain money for services allegedly performed by various doctors to patients of Cornerstone Counseling Center, services which the doctors did not perform. The indictment charges that Medicaid was defrauded of in excess of $500,000, Wellmark was defrauded of more than $200,000, Aetna was defrauded of more than $3,000, and United Health lost more than $6,000. Ellison faces up to twenty years imprisonment, a $250,000 fine, or both if, convicted of health care fraud.
Count five through eight of the indictment charges that Ellison, as part of her scheme to defraud the health care providers, committed aggravated identity theft by using the name and national provider information number (NPI number) of various doctors, without lawful authority. The NPI number is a unique 10-digit identification number issued by the Centers for Medicare and Medicaid Services (CMS) to health care providers for use in billing government and commercial health care insurers. If convicted of aggravated identity theft, Ellison faces a mandatory two years of imprisonment on each count of which she is guilty, a $250,000 fine, or both.
Count nine of the indictment charges Ellison with money laundering, by engaging in a monetary transaction of more than $10,000 with property derived from the health care fraud. Money laundering is punishable by up to ten years imprisonment, a $250,000 fine, or both.
Restitution would be mandatory for any economic loss Ellison caused while committing any crimes of which she is convicted.
The charges in the indictment have, so far, only been established before a federal grand jury by probable cause, and Ellison is presumed innocent unless she pleads guilty or the government establishes her guilt at trial by proof beyond a reasonable doubt.
The investigation was a collaborative effort of the Iowa Medicaid Fraud Control Unit, the United States Department of Health and Human Services Office of Inspector General, the Internal Revenue Service Criminal Investigation Division, and the Iowa Insurance Fraud Bureau. The case is being prosecuted by the United States Attorney’s Office for the Southern District of Iowa.