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Healthcare Fraud Ringleader Given 15 Year Jail Term

The ringleader in a healthcare fraud and identity theft ring, that fraudulently obtained $24 million, has been sentenced to serve 15 years in a federal jail for her crimes. Ten other co-conspirators were also sentenced for their part in the fraud ring, resulting in jail terms of up to 13 years being issued. In addition to the 15 years jail term, Lanier has been ordered to repay $6 in restitution.

Earlier this year, Keshia Lanier of Newnan, GA, pleaded guilty to one count of wire fraud and one of aggravated identity theft. Protected Health Information of patients of the Alabama Department of Public Health, a military hospital, and other healthcare providers was stolen and used to defraud the U.S Treasury by filing fraudulent tax returns.

The government has gone to great lengths to bring all concerned to justice. A number of state and federal agencies were involved in the long-running investigation, and the sentencing of Lanier and her co-conspirators brings to an end an extensive and highly evolved identity theft and fraud ring.

U.S Department of Justice acting assistant attorney general, Caroline D. Ciraolo, released a statement regarding the case saying, this “brings to a close an extensive criminal network led by Keshia Lanier and designed to victimize U.S. citizens and defraud the U.S. Treasury of over $20 million in fraudulent refund claims,” She went on to say, “the substantial sentences imposed on Ms. Lanier and her co-defendants send a clear message that those who chose to engage in such criminal conduct will pay a very heavy price.”

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The government is keen to crack down on identity theft and fraud resulting from the theft of Protected Health Information from healthcare providers. In recent months a number of individuals have been investigated and arrested, and federal agencies have been told to increase the resources devoted to investigating this type of crime.

Healthcare providers are going to great lengths to protect data from cybercriminals and malicious outsiders; however the threat from within must not be ignored. Unfortunately it is difficult to eradicate risk. Access must, after all, be provided to medical staff in order for them to provide medical care to patients and those access rights can be used inappropriately.

In this case, Lanier and her co-conspirators made contact with individuals working in a number of healthcare facilities, and access rights to patient files were abused to allow them to steal the data necessary to file fraudulent tax returns and commit identity theft.

One of the co-conspirators, Tracy Mitchell, was sentenced earlier this year. Mitchell had previously worked at a Fort Benning, GA. military hospital and used her access rights to data to steal the personal information of soldiers and other military personnel. That information was subsequently used to file false tax returns.

The crimes occurred between January 2011 and December 2013, with Lanier, Mitchell and others using stolen data to file over 9,000 federal income tax returns, worth approximately $24 million. Over $10 million was paid out by the IRS before the crimes were discovered. For her role in the crimes, Mitchell was ordered to serve 10 years in jail.

Tamaica Hoskins of Phenix City, AL. also received a lengthy jail term of 12 years, Dameisha Mitchell of Phenix City received a 65 month sentence, Talarius Paige, also from Phenix City was given a 5 year sentence. The other co-conspirators received jail terms of between one and three years.

The sentencing is hoped to send a message to all would be identity thieves and fraudsters that the government is now going to great lengths to bring fraudsters to justice, and will be seeking the maximum possible jail terms for individuals involved in domestic and international fraud rings.

Author: Steve Alder is the editor-in-chief of HIPAA Journal. Steve is responsible for editorial policy regarding the topics covered on HIPAA Journal. He is a specialist on healthcare industry legal and regulatory affairs, and has several years of experience writing about HIPAA and other related legal topics. Steve has developed a deep understanding of regulatory issues surrounding the use of information technology in the healthcare industry and has written hundreds of articles on HIPAA-related topics.