Rebecca Lee Rabon, 44, of Houston, has pleaded guilty to one count of conspiracy to commit health care fraud and five counts of health care fraud in relation to a health care fraud scheme that billed Tricare and Blue Cross and Blue Shield of Texas more than $3.7 million, announced U.S. Attorney Kenneth Magidson.
Rabon is a licensed speech therapist and the owner and operator of Rabon Communication Enhancement (RCE), a speech therapy clinic for children.
At the hearing today, she admitted that she worked together with Tiffany Nicole Thompson, 31, to submit claims to insurance providers for services that were not medically necessary and not provided. Rabon further admitted that between March 29, 2009, and Nov. 11, 2013, her clinic did not have the equipment or supplies to provide treatment for dysphagia – a swallowing and oral feeding dysfunction – and that neither she, nor any speech therapist employed at RCE, provided any of those treatments to children at the clinic.
Rabon further admitted she submitted $925,140 in false and fraudulent claims for herself and Thompson and three unsuspecting RCE employees for various medical and speech therapy services that were not provided, and including $110,550 in false and fraudulent claims under the medical insurance of one unsuspecting employee. Rabon admitted she and Thompson sent a forged letter to Blue Cross and Blue Shield of Texas with a false address for the employee to prevent the employee from discovering the fraud.
In total, Tricare and Blue Cross and Blue Shield of Texas received approximately $3,784,642 in false and fraudulent claims from Rabon and paid her approximately $1,285,827 on those claims.
Rabon has been in custody since Jan. 23, 2015, for violating the terms of her pre-trial release.
U.S. District Judge Melinda Harmon has set sentencing for June 19, 2015, at which time Rabon faces up to 10 years in prison and a possible $250,000 maximum fine.
Thompson, of Katy, has also pleaded guilty to conspiracy and health care fraud charges related to the scheme and will be sentenced April 17, 2015.
The investigation into Rabon and Thompson was the result of an investigation conducted by agents from the Department of Defense – Criminal Investigative Service with assistance of Blue Cross and Blue Shield of Texas – Special Investigations Department. Assistant U.S. Attorney Julie Redlinger is prosecuting the case.
SOURCE: U.S. Attorney’s Office, Southern District of Texas
Okay, but what about the children/patients whose insurance information was misused for the fraudulent enterprise? Have their records been corrected so that they do not suffer loss of benefits in the future? I hope so.