Mississippi businessman sentenced for alleged $510 million insurance fraud scheme | Insurance Business America
A Hattiesburg, MS businessman was sentenced to 18 years in prison for his alleged role as the “kingpin” in a complex fraud scheme that cost medical insurance companies over $510 million.
Wade Walters, 54, was sentenced by US Senior Judge Keith Starrett to 108-month prison terms on each of the two counts he plead guilty to. In a July plea bargain, Walters pleaded guilty to charges of conspiracy to commit health care fraud and conspiracy to commit money laundering. He was also ordered to pay a $250,000 fine and restitution of $287.7 million.
“This case is probably the largest fraud case ever tried in the state of Mississippi,” Judge Starrett told Walters during sentencing. “In addition to being a monumental, huge fraud, this fraud was orchestrated by your abilities. You were very much an integral part of this.”
The insurance fraud scheme entailed claims for medications that, in many of the cases, were unnecessary or did not even work. In particular, the scam typically involved claim reimbursements for expensive, specially formulated pain cream. The fraud scheme ran from 2012 to January 2016.
The scheme was such that it greatly impaired healthcare provider TRICARE, which administers medical insurance to US military veterans. TRICARE had to cut back its offerings and request more funding from the government due to the money it lost to the scam.
WDAM reported that Walters was originally indicted on 37 counts in September 2019. Had he been found guilty on the charges in the original indictment, he could have potentially faced multiple life sentences.