(STL.News) – U.S. Attorney Peter G. Strasser announced that Suzanne C. May, age 61, of Mandeville was charged October 22, 2019 by a Bill of Information with conspiracy to alter or falsify records in connection with a federal investigation, namely, a Medicare audit of a hospice facility located in New Orleans, identified in court documents as Company 1.
According to court documents, MAY was a registered nurse in the State of Louisiana and served as the administrator of Company 1. In 2015, Medicare audited Company 1 and concluded that Company 1 did not have the proper patient documentation to justify Company 1’s level of billing for hospice services. As a result, Medicare reversed all the claims for hospice services under review in that audit, which amounted to $383,107.26. In connection with that audit, Medicare sent an education letter to MAY regarding what was required of Company 1 in order to bill for hospice services.
In August 2017, Medicare performed another audit of Company 1 and requested patient documentation for 99 beneficiaries for whom Company 1 submitted claims for purportedly providing hospice care services. MAY was in charge of gathering the documents requested by the August 2017 audit. After reviewing Company 1’s files for these beneficiaries, MAY understood that Company 1 did not have the required records to justify Company 1’s billings to Medicare for purported hospice care services for the claims under review.
According to court documents, between August 2017 and October 2017, MAY and other employees of Company 1, altered, amended, and falsified patient records to hide the fact that Company 1 lacked required medical records to justify bills submitted to Medicare for purported hospice services for the beneficiaries at issue in the audit. Court documents detail an instance where MAY placed whiteout on one patient record and created a note on that record indicating that she treated that patient as a nurse in November 2014, when she had not done so. MAY caused all these falsified patient records to be submitted to Medicare in response to the August 2017 audit so that Company 1 would pass the Medicare audit. Despite the falsifications, Medicare still determined that Company 1’s patient records were still largely deficient.
If convicted, MAY faces a possible maximum sentence of 5 years imprisonment, a $250,000 fine, and up to three years supervised release in addition to a $100 special assessment.
U.S. Attorney Strasser praised the work of the Federal Bureau of Investigation, the Department of Health and Human Services, and the Louisiana Attorney General’s Office’s Medicaid Fraud Control Unit for their work investigating the case.
U.S. Attorney Strasser reiterated that the Bill of Information is merely a charge and that the guilt of the defendant must be proven beyond a reasonable doubt.