A South Carolina man recently pleaded guilty in a federal court to charges related to a national health care fraud scheme. This man, along with three alleged co-conspirators from other states, was indicted on mail fraud charges in June 2013. The charges against the other three individuals are pending. These defendants will remain innocent until their guilt is proved beyond a reasonable doubt as an indictment is not evidence of guilt but only an allegation.
During the plea hearing, the defendant acknowledged that he had been part of a scheme to promote and sell health care plans to thousands of people who were unaware that the plans were not supported by any insurance companies. He also admitted to embezzling some of the funds that represented the premiums paid by unsuspecting policyholders. The defendant and his co-conspirators apparently redirected in excess of $5.4 million of those funds to their personal accounts. In further acknowledgement, the defendant admitted the majority of the claims were never paid and accepted responsibility for over $7.3 million in losses the fraud caused.
The charges to which he pleaded guilty included wire fraud and conspiring to commit wire fraud, money laundering and embezzlement of a health plan. The sentencing hearing is scheduled for January 2016, and it was reported that he may face more than 20 years behind bars if he is convicted. Furthermore, he may be ordered to recompense those who unknowingly purchased fraudulent health care policies, and he will likely have to forfeit the proceeds earned from his crimes.
Despite the predictions of what this South Carolina man’s fate may be if he is convicted, his agreement to plead guilty to the above charges may benefit him at the formal sentencing. Any person accused of mail fraud or other white collar crimes may benefit significantly from securing the services of a legal representative who will not only protect the client’s legal rights but will also advocate on his or her behalf during plea negotiations. An experienced South Carolina criminal defense attorney can determine whether any mitigating circumstances exist that might be presented to the court in pursuing a sentence that is less severe.
Source: 7thspace.com, “FBI: Second Person Pleads Guilty in Smart Data Solutions LLC National Health Care Benefits Scheme“, Nov. 4, 2015