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May 13, 2013

KC employee pleads guilty in health care scam

Federal prosecutors say Matt Tholen, a Fire Department emergency medical technician, was among seven city and Jackson County employees who submitted false health insurance claims to earn thousands of dollars worth of gift cards.

A Kansas City employee pleaded guilty Monday to taking part in a scheme to defraud the city’s health insurance provider.

Matt Tholen, 29, an emergency medical technician with the Fire Department, was among seven Kansas City and Jackson County employees charged in December with abusing a wellness program that allowed participants to earn gift cards by participating in physical activities and diet programs.

Tholen submitted fraudulent information on behalf of 62 employees or others who were covered by the insurance plan, according to a written plea agreement filed in U.S. District Court in Kansas City. That resulted in the issuance of 144 gift cards totaling more than $17,000, federal prosecutors said.

One fraudulent submission by Tholen involved claims for a 5-year-old who he said completed two marathons and two triathlons.

Tholen is the first defendant to plead guilty in the case, which resulted in a loss of $300,000. He pleaded guilty to one count of wire fraud, which carries a maximum sentence of 20 years in federal prison without parole. A sentencing date has not been set.

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