An act of “simple theft” by a health care worker may not be prosecuted as health care “fraud,” the 3rd U.S. Circuit Court of Appeals has ruled, overturning the conviction of a woman accused of stealing more than $240,000 from the cash payments made by patients of a Pittsburgh methadone clinic.
In its 11-page opinion in United States v. Jones, a unanimous three-judge panel concluded that prosecutors failed to establish an essential element in their case against Aimee Jones because they never proved there was “any type of misrepresentation by Jones in connection with the delivery of, or payment for, health care benefits, items, or services.”
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