Two women were charged Monday with stealing $5.9 million in healthcare fraud claims in Fort Worth, Waco and Temple.
A total of $30 million in workers’ compensation money was stolen in the scheme, KWTX reported.
Melissa Sumerour and Latosha Morgan were office administrators at medical clinics that treated workers’ compensation patients. Morgan worked at Fort Worth and Sumerour worked on behalf of Waco and Temple clinics. The clinics were not identified in charging documents.
According to the Falls County Sheriff’s department, the women were part of a larger scheme involving the clinics’ doctor in central Texas. The doctor was not identified in charging documents.
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According to charges, the women conspired with the clinics’ doctor, referred to as “Physician A,” to fraudulently file claims with the Office of Worker’s Compensation. They would change billing submitted by other doctors to maximize their own billing for each service.
By maximizing billing amounts, the women would receive more money for themselves in monthly bonuses. Morgan received 2 percent of total amount billed, resulting in bonuses up to $6,000 per month. Sumerour received 1 percent bonuses, according to charges.
For example, the charges state, the women would bill the worker’s compensation office for physical therapy services that did not actually occur. They also instructed other workers to bill these false claims.
From January 2011 to March 2017, Sumerour and Morgan submitted or caused the submission of about $5.9 million in false claims under the Federal Employees’ Compensation Act.