Brazen marital healthcare scheme ends with guilty pleas
A former doctor in Alabama and her wife have pleaded guilty to multiple charges in a healthcare fraud scheme run out of their small chain of medical clinics, with the former also pleading guilty to the unlawful distribution of opiates.
The U.S. Department of Justice said Francene Aretha Gayle and her wife, Schara Monique Davis, were billing insurance for patient visits that never occurred, including times when Gayle was not in the office or out of town. The fraud happened over several years.
The couple worked together on the scheme, with Davis serving as the owner and manager of Gayle’s multi-clinic practice, the DoJ said. They were brought up on charges in 2022 after an FBI and DEA investigation.
Both Gayle and Davis have pleaded guilty to one count each of healthcare fraud and a second charge of wire fraud. Gayle also admitted to five counts of illegally distributing controlled substances, which the DoJ said included oxycodone, hydrocodone and methadone.
The DoJ did not provide details on the illegal drug distribution. However, they said Gayle’s medical license was revoked in 2020 due to her prescribing practices. Their clinics all shuttered shortly after.
Despite the closure of their practice, Gayle and Davis applied for and obtained more than $450,000 in funds from COVID-19 disaster relief efforts, including Payment Protection Program (PPE) loans. The funds were used on “other things” unrelated to the practice, the DoJ said in a statement.
Caught but not stopped
Gayle and Davis’s medical billing scheme was originally flagged by Blue Cross Blue Shield of Alabama in 2015. During an audit of the clinics, the insurer discovered that Gayle was absent and other staff were seeing patients, yet all office visits were billed under her name. According to the DoJ, Gayle promised to fix the error. Yet, the fraud continued into 2020, with Medicare, Medicaid and Blue Cross paying out more than $2.3 million for patient visits during the interim.
The couple awaits sentencing. Davis could face a maximum of 30 years in prison. Due to the additional drug charges, Gayle could serve up to 50 years.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.