Barnstable Man Guilty in HMA Direct Insurance Fraud Scheme

William O’Brien, of West Barnstable, was one of four men that pleaded guilty Tuesday in connection with their participation in a fraudulent scheme perpetrated through a Massachusetts health insurance company known as HMA Direct.

O’Brien pleaded guilty to conspiracy, wire fraud, health care fraud, and obtaining customer information from a financial institution by false representation, according to a press release.

HMA Direct offered self-funded insurance plans to small businesses in New England. At the heart of HMA Direct’s business was “carving out” from its clients’ self-funded plans those employees who had significant health risks, and then, through false statements, arranging for those employees to be insured through traditional health insurance providers.

O’Brien participated in the carve-out scheme and subsequent lies to the health insurance providers. He also arranged for Francis Gaetani and Ronald Anger, two of the others pleading guilty, to pretend that they were satisfied customers of the company and to provide fake references to prospective clients. Gaetani and Anger were investors in HMA Direct.

For O’Brien, Gaetani, and Anger, the maximum sentence under the relevant statutes is 20 years in prison, three years of supervised release, and a $250,000 fine. Sentencing is scheduled for Jan. 14, 2015.

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