NORFOLK, Va. - A former sales rep for Home Care Supply, the nation's largest independent HME, could be going to jail for forging physician signatures on CMNs and fraudulently billing insurers for roughly $460,000.
Between May 1999 and January 2003, Amy E. Gowin lied on medical documents by indicating that patients needed equipment or medication that their doctors had not prescribed, court records show. She provided false test results and medical conditions and forged the signatures of 54 physicians on documentation for 179 patients, the Virginian-Pilot reported last month.
Gowin, 29, of Chesapeake, Va., pled guilty to the charges in late April.
Home Care Supply discovered Gowin's transgression in 2002, conducted an internal investigation and disclosed the findings to the federal government. The company fired Gowin in 2002.
“We got kudos from the feds, but you are never happy about a 29 year old who messed up her life,” CEO Todd Christopher said last month. “She is not the first person we have dismissed because of a compliance violation, but she is the first who could get a jail sentence and a fine.”
Gowin was a salaried employee who also received bonuses and commissions based on monthly sales and equipment rentals. Pressure to meet her numbers, however, was no excuse for committing fraud, Christopher said.
“Whether it's Lincare, Apria, us, Rotech or the local mom and pop, everyone is under some pressure to drive revenue,” he said.
In addition to greed, laziness also may have played a role in Gowin's actions. In many instances, the patient needed the equipment, and Gowin had no reason to forge a physician's signature - other than not wanting to take the time to get it, Christopher said.
“When you have a patient out there with an O2 concentrator who is qualified, why do you want to forge the doctor's signature?” he said. “I think she got on such friendly terms with some of her accounts that it became second nature to say, ‘Oh, they won't mind. I can sign their name.' But it is a felony.”
Home Care Supply will repay the $460,000 Gowin billed fraudulently.
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