O’Fallon woman on cruise during some of fraudulently billed work

From Illinois Business Journal news services

EAST ST. LOUIS – An O’Fallon woman  was on a cruise or otherwise out of the country during times when she was charging hundreds of thousands of dollars for health-care work she was not doing, authorities said today.

Stephen R. Wigginton, U.S. attorney for the Southern District of Illinois, said Ann Marie Sheppard, 54, pleaded guilty Wednesday in federal court to charges that she engaged in a scheme to steal from a health-care program and committed mail fraud.

Sentencing has been set for Feb. 10, 2016. Sheppard will face up to 10 years in prison, a fine of up to $250,000, and up to 3 years of supervised release.

During her plea hearing, Sheppard admitted that she had submitted false and fraudulent bills in relation to her alleged performance of personal assistant services in the Home Services Program, a Medicaid Waiver Program designed to allow individuals to stay in their homes instead of entering a nursing home. Sheppard admitted to falsely billing the program between June 30, 2013 and April 30, 2015, when she purportedly rendered personal assistant services to a customer when, in fact, she had not because she was out of the country for 11 days and on an ocean cruise for four days, along with other times she was not with the customer. As a result, Sheppard improperly billed 2,883.4 hours of services and obtained $34,168.33 in payments for services not performed.

This prosecution is part of the fourth wave of the “Operation Home Alone” initiative announced on June 5, 2014, by Wigginton. The investigation was conducted by the U.S. Department of Health and Human Services – Office of Inspector General, the Illinois State Police – Medicaid Fraud Control Bureau, and the Federal Bureau of Investigation. The case is being prosecuted by Assistant United States Attorney William E. Coonan.
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