GLEN CARBON — A Madison County nurse practitioner has pleaded guilty to health care fraud.
Jami L. Mayhew, 41, of Glen Carbon, pleaded guilty Tuesday to a single-count felony information charging her with healthcare fraud. According to court documents from May 30 to June 26, 2017, Mayhew participated in a scheme to defraud Medicare by performing medically unnecessary visits in nursing homes in Madison and St. Clair counties.
Court documents state Mayhew carried out the scheme by seeing nursing home residents multiple times, examining them for only a few minutes at a time, generating progress notes she knew contained misrepresentations and materially false statements about the services she had performed, and falsely reporting that her visits met the billing requirements for complex subsequent nursing home encounters, when in fact they had not.
As part of her guilty plea, Mayhew admitted she knowingly caused 251 false claims to be submitted to Medicare during the charged timeframe. Medicare paid her employer, General Medicine, P.C., more than $23,000 for those visits. She received $27 from the company for each of the false claims for a total of $6,777.
Sentencing is scheduled for Dec. 10. Healthcare fraud is a felony punishable by up to 10 years in prison and a $250,000 fine.
The investigation of the case was a collaborative effort by the Department of Health and Human Services – Office of Inspector General, the Illinois State Police Medicaid Fraud Control Bureau, the Department of Labor – Office of Inspector General, the Department of Labor – Employee Benefits and Security Administration, the Federal Bureau of Investigation, the U.S. Postal Inspection Service and the Defense Criminal Investigative Service. The case is being prosecuted by Assistant U.S. Attorney Nathan D. Stump.