Jail term for couple in health care fraud

A Filipino couple will spend time in jail for health care fraud that cheat the CNMI government over $700,000 in questionable insurance claims by a physical therapy service provider they manage.

Emmanuel Silvino and his wife, Dinnalyn, of MegaPlus International CNMI Inc., were sentenced yesterday by U.S. District Judge Alex R. Munson in a case that the prosecution described as “difficult and complex.”

Mr. Silvino was meted four years and three months imprisonment on one count of health care fraud, while Mrs. Silvino got a much lower sentence of seven days in jail.
Both, however, will have to pay jointly the CNMI government $709,841.35 in restitution for the crime, plus $100 in special assessment fee for each of them.

They will also face deportation immediately after serving prison term or undergo two years of supervised release for Mr. Silvino and three years for his wife if the deportation proceedings are not effected.

The court will seize properties of the couple here and in the Philippines as they agreed to forfeit their claims on those to pay for restitution under a plea agreement.

The couple, who has four children, pled guilty last April to one count of health care fraud, prompting federal prosecutors to drop other charges in the complaint which was filed immediately after their arrest by the Federal of Bureau Investigation agents.

They admitted submitting fraudulent records to collect insurance claims between June 1997 to December 1999 under the government’s health insurance programs on behalf of their patients.

They falsified prescriptions and doctors’ referral program among other things to receive payment from the CNMI government, according to court documents.

The FBI had pursued the case after the CNMI public auditor’s office discovered fraudulent documents submitted by MegaPlus to claim government insurance payment.

Light punishment

Judge Munson imposed a lighter punishment against Mrs. Silvino for her decision to accept responsibility for her actions and substantial assistance to both local and federal authorities during the investigation.

He also considered her role in the scheme as “minor” compared to Mr. Silvino whom he cited for attempting to obstruct justice during the pre-sentencing investigation conducted by the U.S. Probation Office.

Mr. Silvino and his lawyer Perry Inos appealed at the last minute to Judge Munson for leniency, describing a letter he wrote to probation officer Margarita Wonenberg as “confused statement because of pressure and tension.”

The letter dated June 19, which the court kept under seal, reportedly placed much of the blame to his wife and her sister who died of lupus early this year.

Although apologetic, Mr. Silvino admitted lying to the probation officer when questioned by lead prosecutor Assistant District Attorney Kevin Seely during yesterday’s sentencing.

The prosecution also dismissed claims that the defendant was confused since he had already entered into a plea agreement when the letter was written.

In rejecting leniency, Judge Munson said the letter was a “calculated lie” to diminish his responsibility for the crime and blame his wife and her late sister.

He also nixed appeals and petitions submitted by the couple’s fellow church members and clients against harsh punishment, including a pastor who testified on behalf of Mr. Silvino during the sentencing. The couple belongs to a Christian denomination whose members attended yesterday’s proceeding in support of the two.

While Mr. Seely recommended 46 months which was within the range of the guideline, the sentence imposed by the court was the higher end as Judge Munson said he didn’t believe Mr. Silvino had accepted responsibility for his action.

Sufficient

He also stressed that the jail sentence is sufficient to deter other people from stealing money from health insurance as he noted that Mr. Silvino could not have spent the entire money at one time.

Mr. Silvino was immediately handcuffed by the U.S. Marshal after the sentencing, while his supporters wept quietly as he was being frisked out of the court.

Mrs. Silvino, on the other hand, escaped severe penalties as Judge Munson granted a motion for a lesser culpability as she had been “extremely useful” to the prosecution.

Mr. Seely also told the court that she agreed to be interrogated after their arrest without a lawyer and even to testify against her husband if it had gone to trial.

He pointed out that MegaPlus even hired a lawyer for Mr. Silvino, while the wife had to settle for a court-appointed counsel. The prosecution recommended a sentence of probation.

Mrs. Silvino is expected to serve her one-week jail term beginning today, while her husband will be flown to the U.S. mainland.