Alabama state lawmaker arrested over alleged Medicare reimbursement scheme

An Alabama state lawmaker has been charged for his alleged role in a scheme to defraud Medicare and pay kickbacks to a physician’s office, federal prosecutors said Thursday.

The charges against state Rep. Ed Henry (R) center on his work with a business he owned between 2015 and 2017, the U.S. Attorney’s Office for the Middle District of Alabama said. 

The business, MyPractice24, provided chronic care management services to Medicare recipients who had two or more chronic conditions. Physicians would then pay MyPractice24 a share of the Medicare reimbursements, prosecutors said.

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Henry entered into an agreement with Montgomery physician Gilberto Sanchez in 2016 under which the lawmaker would pay kickbacks to Sanchez’s office in exchange for the practice referring Medicare beneficiaries to MyPractice24 for chronic care management services, prosecutors allege.

Those alleged kickbacks included payments to Sanchez’s staff, free chronic care management services, free medical billing services and free clinical services. 

Henry also allegedly assisted Sanchez in paying kickbacks to patients who enrolled in the chronic care management program. According to prosecutors, those kickbacks were paid by Sanchez by waiving copays required by Medicare.

Sanchez has already pleaded guilty to drug distribution, health care fraud and money laundering charges. 

Henry has been charged with one count of conspiring to pay kickbacks and to defraud the United States, six counts of paying unlawful kickbacks, one count of conspiring to commit health care fraud, five counts of health care fraud and one count of conspiring to commit money laundering.