Prison For Humana Execs In Kickback Scheme

September 15, 2015 - 4:12pm

Thomas McAdam

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Former Humana Inc. regional sales director, Glen Allan Fine and former Humana Inc. sales manager, James E. Wenger, were sentenced September 10, 2015, by Senior Judge Charles R. Simpson III, in United States District Court, to one year and one day in prison, and ordered to pay $100,000 each in restitution and forfeit $900,000 each, for their roles in a racketeering and bribery scheme, connected with their former position, announced United States Attorney John E. Kuhn, Jr.

“Fine and Wenger unlawfully diverted millions of dollars in a kickback scheme that took advantage of their positions of trust and authority at Humana,” stated U.S. Attorney John Kuhn. “We simply cannot allow the integrity and efficiency of the health insurance market to be compromised by underhanded, back-door deals.  The prison sentence and restitution order is a just outcome.”

“As this sentencing shows, it is increasingly important for all of us to remain vigilant against corporate fraud.  As corporate insiders, Wenger and Fine abused their positions to obtain approximately $2,000,000 each in unlawful kickbacks.  The FBI, and its law enforcement partners, will continue to work together to hold those who abuse their positions of trust accountable,” stated Howard Marshall, Special Agent in Charge, FBI Louisville.

“These individuals used their positions at a Medicare contractor to demand kickbacks from insurance agents who wanted to market Medicare plans,” said Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General in Atlanta.  “This type of crime harms the integrity of the program and will not be tolerated.”

“The U.S. Postal Inspection Service will continue to strongly pursue its mission of investigating Mail Fraud crimes and protecting the US Postal Service and its customers,” stated Inspector in Charge, Dugan Wong, Pittsburg Division, U.S. Postal Inspection Service.

Co-defendants Fine, age 56, and Wenger, age 50, both of Louisville, previously pleaded guilty, in 2013, to a single count federal information charging them with taking kickbacks totaling over four million dollars while employed as part of Humana’s sales and marketing division known as the MarketPoint Organization.

According to their plea agreements, Fine admitted that in 2005, he, along with Wenger and others, met at a hotel in Florida to discuss sending insurance agents to Shep Cutler, one of the larger Managing General Agencies (MGA) and Dan McNerney, one of his business partners, and also a MGA. Fine and co-defendant Wenger, agreed to send insurance agents, who wanted to sell Humana Medicare Advantage and Prescription Drug Plan products, to Cutler and McNerney in exchange for Cutler sending payments to Fine and Wenger. The four agreed to split the override fees, and each would receive payments of 25%. Fine and Wenger agreed to set up fictitious business accounts in their wives' names. Fine and Wenger admitted to sending agents to Cutler and McNerney's MGAs, and acknowledged their wives did not provide any service in exchange for the money received from Cutler. Fine and Wenger were not authorized by Humana to enter into a kickback relationship with Cutler and McNerney. Both Fine and Wenger received approximately $2,000,000 each for their participation in the scheme. As a result of this kickback arrangement, Humana suffered a loss to its business, and had to pay legal and other investigative costs.

This case was prosecuted by Assistant United States Attorney Lettricea Jefferson-Webb and was investigated by the Federal Bureau of Investigation (FBI), the Department of Health and Human Services, Office of Inspector General, and the United States Postal Inspection Service, with assistance from Humana Inc.



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