A 71-year-old Oakland County woman, Mary Smettler-Bolton, was convicted for her involvement in a Medicare kickback conspiracy that caused a staggering $1.4 million in losses to the program.
During the trial, evidence showed that Smettler-Bolton played a part in a scheme where she referred Medicare beneficiaries to various home health companies around the Metro Detroit area. These referrals were not acts of kindness but transactions, for which she received illegal kickbacks to blatantly enrich herself. According to the Department of Justice, the co-conspirators in this fraudulent activity contributed to a significant loss to Medicare over four years.
Consequences for such activities are severe, with Smettler-Bolton facing up to five years in prison for the conspiracy charge. Additionally, the Anti-Kickback Statute violation could lead to a maximum sentence of 10 years. Details about the sentencing guidelines and statutory factors from the court suggest that these are not taken lightly. Her sentencing is scheduled for March 3, 2025.
The case was brought to light by efforts from the Justice Department's Criminal Division, alongside the FBI Detroit Field Office and the HHS-OIG. Addressing the issue, Nicole M. Argentieri, Principal Deputy Assistant Attorney General, has emphasized strictly holding those accountable who attempt to defraud government healthcare programs. The Health Care Fraud Strike Force Program, operating in numerous federal districts, has been a key player in charging individuals, like Smettler-Bolton, who are involved in health care fraud, leading to billions in billed charges to Medicare.
Prosecutors Ryan Elsey and Shankar Ramamurthy of the Fraud Section’s Health Care Fraud Unit are handling the prosecution of this case. The Unit continues to make healthcare fraud a priority, linking to the broader initiative by the Centers for Medicare & Medicaid Services and the HHS-OIG to take decisive action against fraudulent schemes.
