Seven More Indicted in Houston for Alleged Participation in Health Care Fraud Scheme

Seven additional Houston-area residents who allegedly served as patient recruiters and a nurse have been charged for their alleged participation in a $5 million Medicare home health care fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced Friday. The individuals were scheduled to make their initial appearances Thursday and Friday in U.S. District Court in Houston before Magistrate Judge Stephen Wm. Smith.

A superseding indictment filed October 7, 2010, and unsealed today in U.S. District Court in Houston charges Clifford Ubani, 52; Ezinne Ubani, 45; Princewill Njoku, 51; Caroline Njoku, 45; Mary Ellis, 54; Michelle Turner, 42; Cynthia Garza-Williams, 49; Adelma Casas Sevilla, 44; and Sammie Wilson, 69, with conspiracy to commit health care fraud. Florida Holiday Island, 50; Margaret Pleasant, 45; Estella Joseph, 61; Terrie Porter, 47; and Erica Walker, 30, are charged with conspiracy to pay or receive kickbacks, along with Clifford Ubani, Princewill Njoku, Caroline Njoku, Ellis, Turner, and Garza-Williams. These individuals are also charged with separate counts relating to the payment and receipt of kickbacks. Ezinne Ubani, Princewill Njoku and Ellis are also charged with making false statements in the submission of claims to the Medicare program. Clifford Ubani, Ezinne Ubani, Princewill Njoku, Caroline Njoku, Ellis, Turner, and Garza-Williams were charged in the original indictment filed on June 21, 2010.

Typically, a superseding indictment occurs when the government obtains additional or new evidence and wants to charge more individuals with participation in the alleged scheme. The new evidence is most likely derived from others that have already been indicted and are seeking a better plea deal. The government uses this tactic often in order to bring additional charges against other individuals.

According to the superseding indictment, Clifford Ubani, Ezinne Ubani, Princewill Njoku, and Caroline Njoku were the owners and operators of Family Healthcare Services. The superseding indictment alleges that these owners and operators submitted false and fraudulent claims to the Medicare program for purportedly providing home health care services that were not medically necessary and/or not rendered. According to the superseding indictment, the Medicare program paid Family Healthcare Services approximately $5 million based on the false and fraudulent claims.

Caroline Njoku, Ellis, Turner, Garza-Williams, Wilson, Island, Pleasant, Joseph, Porter, and Walker allegedly recruited Medicare beneficiaries to be placed at Family Healthcare Services for skilled nursing services, and in return allegedly were paid kickbacks by Clifford Ubani, Princewill Njoku, and others for the referrals. According to the superseding indictment, Ezinne Ubani, Princewill Njoku, Ellis, Garza-Williams, and Sevilla allegedly falsified or helped falsify patient files to make it appear that Medicare beneficiaries qualified for and received home health care services that were not medically necessary and/or not provided.

The maximum sentence for committing health care fraud is 10 years in prison. The maximum sentence for conspiracy to pay or receive kickbacks, each individual count of paying and/or receiving kickbacks, and making false statements in determining rights for benefit and payment by Medicare is five years in prison. The superseding indictment seeks forfeiture of assets held by the defendants.

Douglas McNabb and other members of the firm practice and write extensively on matters involving Federal Criminal Defense, Interpol Litigation, International Extradition and OFAC Litigation.

The author of this blog is Douglas McNabb. Please feel free to contact him directly at mcnabb@mcnabbassociates.com or at one of the offices listed above.

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