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Father and Son Duo Sentenced to Jail for Scheme that Defrauded State ACA Programs

A father and son duo from California were each sentenced to serve time in prison for their roles in a scheme that defrauded 12 states’ programs under the Affordable Care Act in excess of $27 million. Jeffrey White, a 63-year-old resident of Twin Peaks, received a sentence of 36 months in prison, followed by supervision of three years following his release. His son Nicholas White, a 35-year-old resident of Twin Peaks, received a sentence of 13 months in prison, followed by supervision of three years following his release.

Alvin Thompson, a U.S. District Judge in Hartford, sentenced both defendants via videoconference. The Whites worked together to commit fraud against various health-care plans that were offered under the ACA, according to statements and documents presented in court. In Connecticut as well as other states, the father and son enrolled individuals in plans offered by the ACA fraudulently, since those individuals didn’t reside in the states where the enrollment was filed.

To further their fraud, the father and son created fake residential leases with fake names for landlords in multiple states. In Connecticut, those locations included Hartford, Norwalk, Farmington and Danbury. What’s more, they also created fake cellphone numbers using online applications. This made it seem more believable that the individuals they were falsely enrolling in the ACA plans actually lived at the location where they said they were.

They then used this fake cellphone number, fake name and fake address to enroll in the ACA plans online. If someone with the government were to call one of the cellphone numbers, they would have reached a cellphone that the Whites controlled.

The father and son paid the premiums on behalf of the individuals so that the ACA plans would be activated. They then also paid to transport these people to their state of California. Once there, they were placed in various residential substance abuse treatment programs that were quite expensive. In turn, these facilities billed the individuals’ ACA plans for treatment they received every week. They billed the plans for expensive toxicology screenings using either urine or blood.

In return for sending these individuals to the treatment programs, the facilities paid both Jeffrey and Nicholas White kickbacks. Each referral returned the Whites a few thousand dollars.

They even arranged with some of the facilities to receive a portion of rebates the facilities received back from the insurance plans offered on the ACA. The Whites looked to maximize what they could receive from their scheme, so they enrolled the people in states whose ACA plans paid out the most for substance treatment programs — even if those people didn’t actually live in that state.

In total, the fraud scheme left states with a loss in excess of $27 million from their ACA plans. The states who suffered a loss include Connecticut, Texas, Tennessee, Pennsylvania, Oregon, Ohio, New Jersey, Kentucky, Indiana, Delaware, California and Arizona.

The father and son profited roughly $1 million from their fraud scheme. However, the judge in their case said they must pay a restitution of more than $27.6 million.

Both of the Whites pled guilty in October 2018. Their charge was conspiracy to commit health-care fraud (one count).

They were released after that date on bond, but soon must report to jail.

Durham said that he believed this case to the first that involved enrolling individuals fraudulently to ACA plans on a scale that spanned multiple states.