[Updated May 2019] Here is a story we don’t see very often. An “optometrist” previously convicted of Medicaid fraud just a few years ago is apparently at it again. According to an indictment unsealed on December 15th, “Doctor” Prince has been charged with 25 counts of Medicare fraud.
Dr. Prince has led an interesting life. In 2009 she was arrested by Georgia authorities and charged with Medicaid fraud. A year later she was convicted. As part of her punishment, Prince was ordered to not work for any entity that receives Medicare or Medicaid funding.
The 2009 prosecution took place in DeKalb County, Georgia. Evidently Prince didn’t learn her lesson. According to a new indictment, Prince is in trouble again and still in Georgia but this time on federal charges. (Click here for the 2009 indictment).
According to court records, Prince owned an eye clinic in Jasper, Georgia and also worked at a nearby clinic owned by her brother. Both clinics provided both optometry and ophthalmology services. The latter services must be performed by a medical doctor.
The clinics hired two optometrists, but no medical doctor to perform ophthalmology services such as surgery. Together Prince and the two contract optometrists visited churches, senior living facilities and large housing complexes. There they examined and treated a large number of patients.
Those worried about the cost of services were told that Medicaid or Medicare would foot the entire bill. Sounds like a deal simply too good to be true.
It was. There were many problems with this arrangement. The most obvious was Prince’s ban from working at any provider that receives government healthcare dollars. That may have been the most obvious problem, but Prince has a much more severe problem.
She has never been licensed by Georgia either as an optometrist or medical doctor (ophthalmologist). Prosecutors say that she isn’t even licensed as a dispensing optician meaning she isn’t even eligible to work in a chain store dispensing prescription glasses.
Prince may be talented and even qualified but without proper licensure, it is impossible to know. Public safety demands that she be tested and licensed before treating patients. Luckily there are no reports that Prince harmed anyone.
Prince’s problems get worse. Once she obtained the Medicare billing information for her “patients,” she allegedly billed both the state and federal healthcare programs for expensive surgeries. The good news for the patients is that the surgeries were not actually performed. The bad news for taxpayers is that we paid for these phony surgeries.
Whatever leniency Prince may have received from her first healthcare conviction probably won’t be repeated. If convicted of all 25 counts, she could face 250 years in prison. [Ed. Note: An indictment is merely an accusation, Prince is considered innocent until proven guilty.]
[Update 2019] On January 9th, 2018 a federal jury convicted Matilda Prince of all 29 counts of the indictment. She was allowed to remain on bond pending her sentencing.
Prior to sentencing, the court revoked her bail and ordered her held in jail while awaiting sentencing. After being convicted twice and while awaiting sentencing one would think that most criminal defendants would be on their best behavior. Not Prince. In revoking her bail the court found she had committed yet another crime, stalking!
The Court finds by clear and convincing evidence that Defendant violated the terms and conditions of her bond and conditions of pretrial supervision by violating state law. Specifically, the Court finds that Defendant committed the offense of stalking under New Hampshire state law, N.H. Rev. Stat. § 633:3-a. The Court further finds that there are no conditions of release that will assure that Defendant does not pose a danger to the safety of other persons.
At sentencing, prosecutors asked for a 64 month sentence. “Against the backdrop of her prior conviction, the nature and circumstances of her present offense should weigh in favor of a more severe sentence. Prince needs to be held accountable for her repeated fraudulent actions, and her criminal background coupled with her sophisticated, long-lasting, and fiscally destructive behavior all weigh in support of the government’s recommended sentence of 64 months.”
U.S. District Court Judge Richard Story sentenced Matilda Prince in August to 40 months in prison. She has filed an appeal. Court records indicate she was not released this time and is presently incarcerated in a Bureau of Prisons facility in Ft. Worth, Texas.
Medicare fraud is a huge problem for taxpayers. The FBI believes taxpayers shell out billions of dollars each year for services not medically necessary or never performed.
Most Medicare fraud cases come to light because of whistleblowers. A little used federal law dating back to the Civil War allows whistleblowers to receive huge cash awards for turning in fraudsters.
Medicare Fraud and the False Claims Act
The federal False Claims Act allows people with inside information about Medicare fraud to file a sealed complaint in federal court. If the government ultimately recovers money from the wrongdoers, the whistleblower can receive up to 30% of that recovery.
How big are the awards? In healthcare fraud cases they can be huge. Compare awards under the False Claims Act to the paltry $1000 awards available for those who only pick up a phone and call the Medicare fraud hotline.
To date our whistleblower clients have received over $100 million in awards! Even though only 700 people filed False Claims Act lawsuits last year, the Justice Department paid out over $435,000,000.00 in award monies. Many states, including Georgia, have their own Medicaid fraud award programs.
If you have knowledge of Medicare fraud or other healthcare fraud involving tax dollars, visit our Medicare fraud whistleblower page. give us a call. We can help you collect the maximum award possible. For more information, contact attorney Brian Mahany at or by telephone at (414) 704-6731 (direct). All inquiries always protected by the attorney – client privilege and kept strictly confidential.
MahanyLaw – America’s Medicare Fraud Whistleblower Lawyers