Elite Healthcare Owner Sentenced to Two Years for Defrauding Health Insurer

US Attorney’s Office – Northern District of Texas, April 12, 2022

The owner of a medical consulting company was sentenced today to two years in federal prison for defrauding health insurers, announced U.S. Attorney for the Northern District of Texas Chad E. Meacham.

Steven Berglund, the 52-year-old owner of Elite Healthcare, pleaded guilty to conspiracy to commit wire fraud and healthcare fraud on Nov. 10, 2021 – three days into his criminal trial. He later attempted to withdraw his plea, arguing that the stress of the trial had left him with diminished mental capacity. The court rejected his attempts, ruling that Mr. Berglund had understood his plea and entered it knowingly and voluntarily. He was sentenced Tuesday by U.S. Senior District Judge Terry Means.

At his trial, the government had introduced evidence showing that Mr. Berglund had organized and led an elaborate “pass-through billing” scheme in which health insurers were deceived into paying Palo Pinto General Hospital for laboratory tests were actually performed by out-of-network laboratories. (Due to its status as a rural hospital, Palo Pinto was often able to receive higher reimbursements than urban hospitals or out-of-network labs.)

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