Madison County Nurse Pactitioner Pleads Guilty to Healthcare Fraud

Jami L. Mayhew of Glen Carbon, Illinois, pleaded guilty today to a single-count felony information
charging her with healthcare fraud. Facts elicited at the plea hearing established that, from May
30 to June 26, 2017, the 41-year old nurse practitioner knowingly participated in a scheme to
defraud Medicare by performing medically unnecessary visits in nursing homes located in St. Clair
and Madison counties.

Mayhew carried out the fraudulent scheme by seeing nursing home residents multiple times, examining
them for only a few minutes at a time, generating progress notes she knew contained
misrepresentations and materially false statements about the services she had performed, and
falsely reporting that her visits met the billing requirements for complex subsequent nursing home
encounters, when in fact they had not.

As part of her guilty plea, Mayhew admitted that she knowingly caused 251 false claims to be
submitted to Medicare during the charged timeframe. Medicare paid her employer, General Medicine,
P.C., over $23,000 for those visits. Mayhew, herself, received $27 from the company for each of the
false claims she caused to be submitted, for a total of $6,777.

Sentencing is scheduled for Dec. 10, 2020. Healthcare fraud is a felony punishable by up to 10
years in prison and a $250,000 fine. Members of the public who believe they may have information
related to this or any similar schemes involving healthcare fraud in nursing homes are encouraged
to contact law enforcement by calling the HHS fraud hotline at 1-800-HHS-TIPS (1- 800-447-8477) or
by going online at https://oig.hhs.gov/fraud/report-fraud/.

The investigation of this case was a collaborative effort conducted by the Department of Health and
Human Services – Office of Inspector General, the Illinois State Police Medicaid Fraud Control
Bureau, the Department of Labor – Office of Inspector General, the Department of Labor
– Employee Benefits and Security Administration, the Federal Bureau of Investigation, the United
States Postal Inspection Service, and the Defense Criminal Investigative Service. The case is being
prosecuted by Assistant U.S. Attorney Nathan D. Stump.