Medicare & Medicaid Guide P 42,940 United States of America v. Wendy Miller Desalvo
Opinion
Opinion
Lew, J.
I. Overview
On June 7, 1993 a jury found Appellant, Wendy DeSalvo guilty on eleven counts of an indictment charging conspiracy to defraud the United States and mail fraud. Pursuant to this verdict, on October 27, 1993, District Court Judge D. Lowell Jensen sentenced DeSalvo to 60 months imprisonment and ordered her to pay restitution in the amount of $970,166.75.
DeSalvo’s conviction arose out of activities connected with her employment at H.W. Care, Inc. (“HWC”), a business founded by her sister and co-defendant in the case below, Kristina Rowland Brambila. DeSalvo was the Chief Financial Officer of HWC, a business that provided consulting services for medical care providers, essentially consisting of auditing work for hospitals and nursing homes.
As part of the services offered to providers, HWC would perform “lost charge audits,” which entailed reviewing provider accounting records to uncover any potential under-billings of the Medicare program. When HWC undertook this service, it would enter into a contingency agreement providing that a portion of any money recovered by the provider from Medicare would be paid to HWC as a fee for its service.