05/16/2019 | Press release | Distributed by Public on 05/16/2019 12:34
HARRISBURG - The United States Attorney's Office for the Middle District of Pennsylvania announced that the former owner/operator of a Harrisburg based dental and vision claims processing business, Michael Timothy Buchanan, age 68, of Fishers, Indiana, pleaded guilty on May 14, 2019, before U.S. District Court Judge Sylvia H. Rambo, to one count of Health Care Fraud.
According to United States Attorney David J. Freed, Buchanan admitted to defrauding a trust fund established by the Association of Pennsylvania State College and University Faculties (APSCUF) out of $1,493,629. Buchanan executed a scheme to defraud the Pennsylvania Faculty Health and Welfare Fund (The Fund) between 2007 and 2017 by his submission of false, inflated invoices for the services his company, Actuaries, Consultants and Administrators, Inc. (ACA), provided The Fund 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, Judge Rambo released Buchanan on his own recognizance pending preparation of a presentence 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.
A sentence following a finding of guilt is imposed by the Judge after consideration of the applicable federal sentencing statutes and the Federal Sentencing Guidelines.
The maximum penalty under federal law for this offense is 10 years of imprisonment, a term of supervised release following imprisonment, and a fine. Under the Federal Sentencing Guidelines, the Judge is also required to consider and weigh a number of factors, including the nature, circumstances and seriousness of the offense; the history and characteristics of the defendant; and the need to punish the defendant, protect the public and provide for the defendant's educational, vocational and medical needs. For these reasons, the statutory maximum penalty for the offense is not an accurate indicator of the potential sentence for a specific defendant.
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