Non-DOJ Individual Sentenced for Health Care Fraud

On September 22, 2020, a non-DOJ individual was sentenced to eighteen months of imprisonment and twenty-four months of supervised release, and ordered to pay $437,940 in restitution, for health care fraud.  Melissa Sumerour was previously found guilty at trial in the Northern District of Texas of six counts of health care fraud and not guilty of one count of conspiracy to commit health care fraud.  According to the evidence presented at trial, from in or about January 2011 through in or about March 2017, Sumerour, the office manager and biller for two Texas medical clinics, engaged in a scheme to defraud the Department of Labor’s Office of Workers’ Compensation Programs (OWCP) by overbilling for physical therapy.  The evidence established that the fraud, in which Sumerour billed for more physical therapy than was provided, cost the OWCP in excess of $5.5 million.  The investigation is being conducted by the OIG’s Dallas Field Office, the U.S. Department of Labor OIG, U.S. Postal Service OIG, Veterans Affairs OIG, and the U.S. Army Criminal Investigation Command.