HARRISBURG — The former owner of a Harrisburg-based dental and vision claims processing business pleaded guilty to one count of health care fraud in federal court this week, according to U.S. Attorney David J. Freed.
Michael Timothy Buchanan, 68, of Fishers, Indiana, pleaded guilty on Tuesday, Freed said in a press release.
Buchanan admitted to defrauding a trust fund established by the Association of Pennsylvania State College and University Faculties out of $1,493,629 by submitting false, inflated invoices for services provided by his company, Actuaries, Consultants, and Administrators, Inc., in connection with the processing of dental and vision claims submitted by members of the APSCUF Union.
The Fund paid ACA $5.20 for each vision claim it processed and $8.10 for each dental claim it processed. Buchanan routinely and artificially inflated the number of claims it allegedly processed for The Fund between 2007 and 2017 that resulted in a $1,493,629 overpayment to ACA.
Upon the conclusion of the guilty plea proceeding, Buchanan was released on his own recognizance pending preparation of a pre-sentence report. No date has yet been scheduled for sentencing.
The case was investigated by the Harrisburg Office of the FBI and the U.S. Department of Labor, Office of Inspector General. Assistant United States Attorney Kim Douglas Daniel is prosecuting the case.
The maximum penalty under federal law for this offense is 10 years of imprisonment, a term of supervised release following imprisonment, and a fine.
Source: Former owner of Harrisburg business pleads guilty to $1.5 million worth of healthcare fraud / FOX 43