Prineville woman gets 4 years in federal prison for health care fraud

Published 4:56 pm Wednesday, September 25, 2024

The Wayne L. Morse U.S. Courthouse in Eugene is seen in this stock image. 

A Prineville woman was sentenced Tuesday to four years in federal prison for stealing identities, including some from jail rosters, and using them to submit fake health care claims worth more than $1.5 million, the U.S. Attorney’s Office said in a news release.

During a hearing in federal court in Eugene, Darla K. Byus, 55, was also ordered to pay more than $2 million in restitution to the Oregon Health Authority and the IRS.

In June, Byus pleaded guilty to heath care fraud, aggravated identity theft and filing a false tax return, according to court records.

“Her crimes betrayed the trust placed in this company as a substance abuse treatment provider in Oregon. We thank the state and federal investigators for their dedication and commitment to ending this scheme,” Nathan J. Lichvarcik, chief of the U.S. Attorney’s Office Eugene and Medford branch offices said in the news release. “Business owners who abuse the system to line their pockets at the expense of our communities will be held accountable.”

Documents show that from January 2019 to August 2021, Byus used her company, Choices Recovery Services, to overbill the OHA Medicaid program for substance abuse counseling services and to submit bogus reimbursement claims using the stolen identities of Medicaid recipients, the news release said.

The company was an OHA Medicaid provider for drug and alcohol related counseling services with access to a provider portal through the Medicaid Management Information System, according to court records.

Byus used the information to determine a victim’s Medicaid eligibility, according to the news release. Using victims’ personal information, she submitted more than $3 million in bogus claims without their knowledge or consent. Byus used the stolen identities of more than 45 victims and found about a third of them by searching jail roster websites for those with recent alcohol – or drug-related offenses, the government said.

She received more than $1.5 million in fraudulent proceeds and also filed fake tax returns for herself and the company. She failed to pay about $450,000 in taxes, the news release said.

Prosecutors said she used the money to gamble, and to buy three properties, two in Prineville and one in John Day, according to court records. The government also wants to seize property through forfeiture.

Kurt David Hermansen, an assistant federal public defender and Byus’ lawyer, blamed another person in the Prineville-based Choices Recovery Services, for leading his client astray, but he admitted Byus and others engaged in “irresponsible business practices.”

“The business was recklessly run. They got into a hole,” he said. “Then they decided, well, let’s just commit a bunch of fraud to try to get out of this hole.”

Hermansen urged a more lenient sentence of two years.

U.S. District Judge Michael J. McShane pointed out that the fraud wasn’t a one-time crime but continued over years. He said he selected the sentence after considering the seriousness of the crime, as well as Byus’ traumatic childhood, history of abuse and mental health history, including bipolar disorder and post traumatic stress.

Byus told the judge, “What I did was wrong, and I just didn’t know how to stop doing it and still be able to help the people we were helping.”

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