Healthcare Fraud

   The U.S. Court of Appeals (Court), in a December 12, 2025 decision, considered the appeal of Kristal Glover-Wing  (Glover-Wing) and upheld convictions for conspiracy and healthcare fraud, which is notable given her certification as a Medicare Provider and influence over healthcare providers in her employ. 

In 1999, Glover-Wing was certified as a Medicare provider and founded Angel Care Hospice (ACH) to provide services in Louisiana. She recruited medical directors, who certified patients as “terminally ill,” which triggered Medicare payments. Physicians who disagreed with ACH practices or refused to require patients to only use ACH services were not retained. Additionally, she required nurses to “chart the patient like on their worst day,” “to capture the worst because it’s hospice,” and to falsify patient records by backdating readmissions. The conviction focused on three types of patients, including those with lupus, spinal stenosis, and COPD who were stable in their condition but certified as terminally ill. Glover-Wing was indicted for conspiracy to commit healthcare fraud and three counts of healthcare fraud related to Medicare hospice care reimbursement specifically on the services provided for three (3) patients. In each case, someone disagreed with ACH’s decision to certify a patient as terminally ill.

Glover-Wing brought the appeal challenging the sufficiency of evidence on the charges of healthcare fraud and conspiracy. She also challenged the District Court’s decision to not judicially estop the government from pursuing its conspiracy charges. Glover-Wing argued she lacked clinical qualifications to determine whether a diagnosis was accurate or fraudulent. She also alleged that the conspiracy charge should be invalidated, as two physician co-defendants were acquitted. The government argued that her contentions were without merit. Her instructions to staff as demonstrated at trial evidenced Glover-Wing had knowledge of the fraudulent diagnosis, certifications, and reenrollment of patients.

Here, the Court rejected Glover-Wing’s arguments regarding healthcare fraud. The Court determined that she willingly de-frauded Medicare and billed for patients she knew were not terminally ill and further specifically instructed her staff to manipulate or falsify records, giving the jury sufficient evidence to determine she defrauded Medicare knowingly. Further, the acquittal of co-defendants does not in fact bar a conspiracy conviction for Glover-Wing. The jury considered evidence sufficient to find that a tacit agreement to violate the law was made between Glover-Wing and medical directors with a “pay-to-play” scheme where medical directors were rewarded. The issue of judicial estoppel need not be considered by this court, as judicial estoppel does not apply to this case, since she failed to establish the requisite factors to invoke the doctrine.

Affirmed.