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Tonawanda social worker gets jail in insurance fraud

Thu, Jul 24th 2008 12:00 am
By JODI SOKOLOWSKI
Business First

A licensed social worker who was convicted of health-care fraud on Feb. 20 has been sentenced to 12 months in jail and fined $3,000.

Rhonn Gilchrist, 59, was convicted of defrauding health-insurance companies resulting from his submission of fraudulent claim forms seeking payments for treatment he never provided to patients, according to Assistant U.S. Attorney John Rogowski, who handled the case.

Gilchrist, who had an office on Niagara Falls Boulevard in Tonawanda, conducted the fraud from 2002 to 2007. Sentencing took place in U.S. District Court for the Western District of New York before Hon. William Skretny.

Gilchrist, whose patients included people covered under the New York Workers' Compensation Program or the state's no-fault automobile-insurance law, engaged in double billing, or billing two insurance companies for the full amount of treatment provided.

While a health-care provider may bill two insurance companies for the same treatment, the provider must disclose that fact and repay any amount received over 100 percent of the cost of the service. The defendant did not disclose the double billing and kept the over-payments of $102,000.

Skretny ordered him to make restitution to the insurance companies involved. Gilchrist agreed to a criminal forfeiture of $90,000 in cash and a condominium in Sarasota, Fla., valued at about $400,000, that he purchased, in part, using the illegal proceeds.

The investigation was conducted by the Western New York Health Care Fraud Task Force, consisting of agents from the FBI, U.S. Postal Service, Department of Health and Human Services, Department of Defense, the FDA, the Department of Labor and the New York State Insurance Fraud Bureau.