Feds: Michigan doctor, cohorts targeted UAW workers in $8M kickback scheme
A Michigan doctor and two associates face prison time for their roles in an $8 million health care kickback scheme involving United Auto Workers members, federal officials said Wednesday.
Investigators say Dr. April Tyler of Fenton, along with two associates, Patrick Wittbrodt and Jeffrey Fillmore, targeted the workers' coverage through Medicare and Blue Cross Blue Shield of Michigan because of the high reimbursement rate.
Using Fillmore's connections, the group promoted scar cream, pain patches and vitamins during UAW meetings, telling members they could receive their prescriptions free without paying a cop-pay at the pharmacy, the U.S. Attorney’s Office for the Eastern District of Michigan said in a statement Wednesday.
The cohorts would collect the members' insurance information, and Tyler authorized the prescriptions for them or their relatives, according to the feds.
Although she didn't examine the workers or determine their medical needs, Tyler also pre-signed forms and allowed Wittbrodt and Fillmore to choose which compounded creams, patches and vitamins to write on the prescriptions, prosecutors reported.
Wittbrodt directed the prescriptions to various pharmacies, which would fill each, bill the autoworkers' insurance as well as pay a kickback he then shared with Tyler and Fillmore, court records show.
“According to court documents, the defendants caused an approximate $8,000,000 loss to Medicare and Blue Cross Blue Shield of Michigan,” the attorney’s office said Wednesday. “Some of this money was stolen from UAW members’ prescription insurance accounts.”
The prescriptions were periodically refilled regardless of whether the UAW members requested it.
“These unlawful prescriptions cost the UAW health care fund millions of dollars, and the end result was a rip-off of the hardworking men and women of the union,” U.S. Attorney Matthew Schneider said.
"We will continue to aggressively prosecute health care fraud, and step in to protect UAW workers across Michigan.”
Tyler pleaded guilty Nov. 6 to violating the anti-kickback statute and agreed to 18-24 months in prison, per federal sentencing guidelines, Schneider's office said Wednesday, citing court records.
Wittbrodt, 44, of Grand Blanc and Fillmore, 31, of Clio have both pleaded guilty to healthcare fraud, according to the release. Wittbrodt faces 70-87 months in prison. Fillmore faces 37-46 months.
“We rely on medical professionals to uphold the integrity of the prescription drug programs by only prescribing medications that are medically indicated and necessary,” said Lamont Pugh III, Special Agent-in-Charge at the Chicago Region of the U.S. Department of Health and Human Services Office of Inspector General.
“Circumventing this process solely for personal, financial gain compromises the integrity of these systems and takes away valuable healthcare dollars from patients who truly need the medications.”