Rexford woman convicted of fraud

U.S. Attorney for Montana Michael Cotter announced Nov. 26 that a respiratory therapist from Rexford has been sentenced to 12 months and one day for defrauding Medicaid of more than $1.4 million and filing tax returns that failed to report her correct income, resulting in a tax loss of more than $200,000.

Anna Sue Tope, 67, was the vice president of Eagle Calf Technical Corporation, a company that provided medical equipment and services on the Blackfeet Indian Reservation. Eagle Calf’s clients in the Browning area are generally low-income patients eligible for Medicaid. 

Assistant U.S. Attorney Chad Spraker told the court that Tope had worked at various hospitals and owned a medical supply business prior to starting the Montana company with a business associate in 1998. Tope became the sole signatory for Eagle Calf bank accounts in 2001.

From 2003 until 2011, Spraker said, an Eagle Calf customer received catheter supplies from the company. The patient required the use of one of two types of tracheal suction catheters.  Cath-n-Glove kits, which cost about $2.70 each, are much less expensive than a closed-system catheter, at about $16 apiece. Cath-n-Glove kits are disposable and designed for one-time use, but a patient may require multiple kits each day. A closed-system catheter, however, may be used for a longer period of time — typically multiple days to one week before a patient requires a new one.

Eagle Calf provided Cath-n-Glove kits from the time the patient started receiving supplies from Eagle Calf in 2003 until November 2011. Investigators located six wholesale suppliers who had sold 20,626 Cath-n-Glove kits to Eagle Calf on 59 invoices during the period of the indictment. None of the invoices showed Eagle Calf ever purchased a closed-system catheter from any supplier.

Although furnishing the patient with the less expensive catheter, Tope fraudulently billed Medicaid for the more expensive closed system catheters. Medicaid was billed for more than $1.7 million for more than 108,000 closed-system catheters purportedly supplied to the patient.

Had the Medicaid program not been misled as to the medical equipment actually being provided, reimbursement to Eagle Calf would have been about $300,000. Tope’s fraudulent scheme cost the government $1.4 million, Spraker said.

The case was investigated by the Montana Medicaid Surveillance, Utilization and Review System Unit, the Internal Revenue Service, the Health Care Fraud investigator for the U.S. Attorney’s Office, and the Federal Bureau of Investigation.