FORMER U.S. HOUSE OFFICE MANAGER PLEADS GUILTY FOR PADDING OWN SALARY, TRAVEL EXPENSES

FROM:  U.S. JUSTICE DEPARTMENT 

Friday, July 25, 2014

Former U.S. House of Representatives Employee Pleads Guilty to Theft of Government Property

Brian Prokes, 28, a former office manager in the U.S. House of Representatives, pleaded guilty today for causing the House of Representatives to pay more than $19,000 in excess salary and unauthorized travel expenses, announced Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division.

According to court documents, Prokes worked as the office manager for a U.S. Congressman.   Prokes’s responsibilities included transmitting salary and bonus information to the House of Representatives’ Office of Payroll and Benefits in order to adjust the pay of employees in the Congressman’s office.   Prokes admitted that, between April 2012 and March 2013, he submitted unauthorized paperwork to the Office of Payroll and Benefits to pay himself larger salary and bonus than he had been approved to receive.

In addition, Prokes admitted that, between February 2012 and December 2012, he charged unauthorized, personal travel expenses for himself and an acquaintance to a government credit card used by the Congressman’s office.   The excess salary payments and unauthorized travel expenses amounted to more than $19,000.

Prokes, of Atlanta, Georgia, is scheduled to be sentenced on Oct. 14, 2014, before U.S. District Judge Rudolph Contreras in the District of Columbia.

This case was investigated by the FBI.   This case is being prosecuted by Trial Attorneys Kevin O. Driscoll and Sean F. Mulryne of the Criminal Division’s Public Integrity Section.

HEALTH CARE ORG. & HOSPITAL TO PAY $3.85 MILLION FOR PROVIDING KICKBACKS FOR DOCTOR REFERRALS

FROM:  U.S. JUSTICE DEPARTMENT FINANCIAL 
Tuesday, December 31, 2013
Colorado Health Care Organization and One of Its Montana Hospitals to Pay $3.85 Million for Allegedly Providing Financial Benefits to Referring Physicians and Physician Groups

St. James Healthcare (St. James), a hospital located in Butte, Mont., and its parent company, Sisters of Charity of Leavenworth Health System (Sisters of Charity), a health care organization based in Denver, Colo., have agreed to pay $3.85 million to resolve allegations that they violated the Anti-Kickback Statute, the Stark Law and the False Claims Act by improperly providing financial benefits to physicians and physician groups that made referrals to the hospital, the Justice Department announced today.

The Anti-Kickback Statute prohibits the provision of remuneration with the intent to induce referrals of government health care program business.  The Stark Law restricts financial relationships that hospitals may enter into with physicians who refer patients to them.  Federal law prohibits payment by federal health care programs of medical claims that result from arrangements that violate the Anti-Kickback Statute or the Stark Law.

“Improper financial arrangements between hospitals and physicians not only undermine the integrity of the decisions that doctors make, they raise the cost of health care for all of us,” said Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery.  “The department has longstanding concerns about such conduct and is committed to working with health care providers that come forward to disclose their misconduct.”

The settlement announced today resolves allegations that St. James and Sisters of Charity provided various improper financial incentives to physicians and physician groups that were involved in a joint venture with St. James to own and operate a medical office building on the St. James campus.  These incentives included a payment to the joint venture that increased the share values for the physicians and physician groups in the joint venture and resulted in below fair market value lease rates for the physicians renting space in the medical office building.  Additional incentives provided by St. James and Sisters of Charity included below fair market value lease rates for the land upon which the medical office building was constructed and other below fair market value arrangements related to shared facilities, use and maintenance.  These issues were disclosed by St. James and Sisters of Charity to the government.

“This matter is of great significance to Montanans because it helps ensure federal health care programs deliver services in a cost-effective and efficient manner,” said U.S. Attorney for the District of Montana Michael W. Cotter.  “We are encouraged that hospitals like St. James Healthcare are taking these issues seriously by reviewing their operations and making disclosures to the government where necessary.”

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius.  The partnership between the two departments has focused on efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  One of the most powerful tools in this effort is the False Claims Act.  Since January 2009, the Justice Department has recovered a total of more than $17 billion through False Claims Act cases, with more than $12.2 billion of that amount recovered in cases involving fraud against federal health care programs.

This case was handled by the U.S. Attorney’s Office for the District of Montana, the Department of Justice Civil Division, Commercial Litigation Branch and the Department of Health and Human Services Office of Inspector General.  The claims settled by this agreement are allegations only, and there has been no determination of liability.