Raleigh County Woman Enters Guilty Plea to Health Care Fraud

[Leroy N. Soetoro]

https://www.justice.gov/usao-sdwv/pr/raleigh-county-woman-enters-guilty-
plea-health-care-fraud

U.S. Attorneys » Southern District of West Virginia » News
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Department of Justice
U.S. Attorney’s Office
Southern District of West Virginia
FOR IMMEDIATE RELEASE
Tuesday, February 11, 2020
Raleigh County Woman Enters Guilty Plea to Health Care Fraud
Defendant fraudulently obtained over $300,000

CHARLESTON, W.Va. – Julie M. Wheeler entered a guilty plea for federal
health care fraud, announced United States Attorney Mike Stuart. Wheeler,
43, of Beckley, faces up to 10 years of incarceration, a $250,000 fine,
and three years of supervised release when sentenced on May 20, 2020.
She will also be subject to an order of restitution in an amount ranging
from $302,131 to $469,983, with the final determination to be made by the
Court at sentencing.

“Can you imagine? Wheeler defrauded the Spina Bifida Health Care Benefits
Program and in the process stole hundreds of thousands of dollars from
taxpayers,” said United States Attorney Mike Stuart. “Taking advantage of
the condition of spina bifida of a child for personal greed is truly a
despicable crime. Wheeler even admitted that she defrauded the VA of
hundreds of thousands of dollars and deprived the victim- a child
diagnosed with spina bifida- of services. The VA provides critical
benefits and services to heroic veterans and their dependents. Our
veterans deserve better. The families of our veterans deserve better.
And the victims of terrible conditions like spina bifida deserve all of
God’s graces. Greed is a terribly destructive human condition.”

The VA provided health care benefits to certain Korean and Vietnam War
veteran’s children who were diagnosed with spina bifida through the Spina
Bifida Health Care Benefits Program. Spina bifida is a type of birth
defect where there is an incomplete closing of the spine, potentially
leading to complications including difficulty in walking, poor bladder or
bowel control, and difficulty in mobility. A veteran’s child, K.L.,
received such a diagnosis and qualified for in home care through this VA
program.

Wheeler was related to K.L and was also the owner of a homecare services
company, JRW Homecare Support Services. Wheeler was hired to provide
services to K.L. due to K.L.’s spina bifida condition at the VA approved
rate of $736 a day to provide eight hours of daily services. Wheeler’s
care was supposed to include bathing, grooming, changing K.L.’s clothes
and other issues associated with K.L.’s hygiene, food intake, and
lifestyle.

Wheeler submitted fraudulent applications where she filled out VA forms
and was overpaid for providing care for K.L. Specifically, Wheeler did
not provide K.L. the care for and during the time period described.
Wheeler submitted claims to the VA stating that she provided care for K.L.
eight hours a day, seven days a week, from October 2016 to April 2018 at
the full daily rate of $736 a day. Wheeler gave a statement to the VA and
the FBI admitting that she greatly inflated the rate and quality of the
care that she provided to K.L. This was corroborated by other witnesses
who provided statements that Wheeler did not provide eight hours of daily
care. Wheeler further admitted that her conduct defrauded the VA of
hundreds of thousands of dollars and deprived the victim of services. The
victim of the spina bifida diagnosis, K.L., has since passed away.

Stuart praised the work of the Veterans Affairs - Office of Inspector
General (VA-OIG), the Federal Bureau of Investigation, the Office of
Veterans Affairs (VA), and the United States Department of Health and
Human Services - Office of Inspector General (HHS-OIG). The
investigation was conducted by members of the United States Attorney’s
Healthcare Fraud Abuse, Recovery and Response Team (ARREST), an innovative
approach linking civil and criminal enforcement efforts together in a
comprehensive attack on the opioid epidemic and healthcare fraud. United
States Attorney Mike Stuart announced the formation of ARREST in February
2019. All health care related cases in the Southern District of West
Virginia, whether they are the subject of criminal or civil investigation
or enforcement, are directed through ARREST. Included within the purview
of the team are the Opioid Fraud and Abuse Detection Unit, Affirmative
Civil Enforcement Unit, Appalachian Regional Prescription Opioid (ARPO)
Strike Force, Medicare and Medicaid Fraud, and Asset Forfeiture efforts
related to all healthcare matters.

Senior United States District John T. Copenhaver, Jr. presided over the
plea hearing. Assistant United States Attorney Erik S. Goes handled the
prosecution.



Follow us on Twitter: @SDWVNews and @USAttyStuart


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