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Brooksville psychiatrist exonerated of 148 Medicare fraud charges

Jul 11, 2013 | Fraud

Kesmond Wilson has spent the last two years under the threat of criminal prosecution. He was arrested in late 2011 on 148 counts of suspected Medicare fraud and, when reporters discovered he had a criminal record, he was vilified in the press. He was expected to face trial next Monday.

He was innocent of all charges.

Yesterday, the State Attorney’s Office in Hernando County dropped the case entirely. Just five days before he was to stand trial on the Medicaid fraud charges, which had been consolidated into a charge of insurance fraud, the prosecutor determined that there simply was no evidence that he had done anything illegal.

“The defendant turned over documents and materials that would tend to exonerate him, and in good faith I couldn’t go forward with a criminal prosecution,” explained the assistant state attorney in charge of the case.

Here’s how the apparent mix-up occurred. In Sept. 2011, Wilson bought a psychiatric practice from another doctor who had taken a job as a hospital medical director. The other doctor didn’t know that Wilson was on probation for fraud, theft and forgery, but that issue turns out to have been irrelevant. The two doctors worked together for about two months as the older psychiatrist tapered off his treatment and transitioned his patients to new providers.

It was when Wilson’s check to pay for the purchase bounced that the other doctor contacted the authorities. Later, Hernando County Sheriff’s deputies said they discovered that Wilson and his sister had downloaded patient records to a laptop and used them to file at least 74 Medicare billing transactions. The deputies pounced, and the State Attorney’s Office filed Medicare fraud charges.

As it turns out, when Wilson filed those billing transactions, he included the other doctor’s name as the treating physician, which he was. It was just a case of clearing out the accounts payable file for his new practice.

“Mr. Wilson sending out bills for services provided by [the other doctor] is not against the law,” explained the prosecutor.

“The State Attorney’s Office did the right thing,” says Wilson’s criminal defense lawyer. “There was nothing illegal done in this whole transaction.”



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