MONTGOMERY, Ala. (Dept. of Justice) — On Wednesday, January 16, 2019, William “Ed” Henry, pleaded guilty to one count of theft of government property, announced U.S. Attorney Louis V. Franklin, Sr.  The conviction arises out of Henry’s involvement in a scheme to defraud Medicare. 

According to court documents, when he committed his offense, Henry was the chief executive officer of an Alabama-based company, MyPractice24.  MyPractice24 provided chronic care management services to Medicare Part B beneficiaries, specifically patients with two or more chronic conditions.  Physicians could hire MyPractice24 to perform chronic care management for their patients, and the physicians were required to collect co-pays from such patients of approximately $8 per month.  Medicare would then reimburse the physicians at approximately $32 per patient per month.

On behalf of MyPractice24, Henry entered into contracts with the practices of various doctors around the southeast, including Alabama physicians Gilberto Sanchez, Punuru J. Reddy, and Nicole Scruggs, to provide chronic care management services for those doctors’ patients.  Each doctor agreed with Henry that his or her practice would waive co-pay requirements for patients participating in MyPractice24’s chronic care management program.  Ultimately, Sanchez obtained approximately $119,349.11 from the United States government; Reddy obtained approximately $77,705.26; and Scruggs obtained approximately $7,060.87.  Because the physicians systematically waived patient co-pays for chronic care management services, the physicians were not entitled to be reimbursed for those services.

Henry’s sentencing will be scheduled at some point in the coming months before Chief United States District Judge W. Keith Watkins.  At sentencing, Henry faces up to ten years in prison, a fine of not more than $250,000, and up to three years of supervised release.  

“Henry and his co-defendants treated seriously ill patients as vehicles for getting money from the government,” commented United States Attorney Franklin.  “In doing so, they diverted precious health care resources from paying for health care services that were truly necessary to services that Henry could make a profit from providing.  I am proud of the investigative agencies’ efforts to expose this fraud.”

The United States Department of Health and Human Services-Office of the Inspector General, the Drug Enforcement Administration, and the Internal Revenue Service-Criminal 
Investigation Division investigated this case.  Assistant United States Attorneys Jonathan S. Ross and Megan A. Kirkpatrick prosecuted the case.