Two Houston-Area Residents Charged in Nationwide Medicare Fraud Strike Force Takedown

September 8, 2011

The Federal Bureau of Investigation (FBI) on September 7, 2011 released the following:

Total of 91 Defendants Charged Nationally with Submitting $295 Million in Fraudulent Claims

HOUSTON— The owner of a Medicare referral business and the owner of a medical supply company have been charged for their participation in separate schemes to defraud the Medicare program of more than $62 million, announced the Departments of Justice, Health and Human Services (HHS) and the Texas Attorney General’s Office.

The Houston indictments are part of a nationwide takedown by Medicare Fraud Strike Force operations that led to charges against 91 defendants for their alleged participation in schemes to collectively submit more than $295 million in fraudulent claims to the Medicare program. This takedown involved the highest amount of false Medicare billings in a single takedown in Strike Force history.

“The defendants charged in this takedown are accused of stealing precious taxpayer resources and defrauding Medicare—jeopardizing the integrity of our health care system and our nation’s most critical health care program for personal gain,” said Attorney General Holder. “Our highly coordinated, nationwide Strike Force operations are working aggressively to combat Medicare fraud and our anti-health care fraud efforts have never been more innovative, collaborative, aggressive—or effective. We will continue to work with our law enforcement partners and partners across government to fight against health care fraud.”

“Defrauding our national health care programs affects those who depend on our health care system and cheats the taxpaying public,” said U.S. Attorney Moreno. “Those who defraud the system, no matter what their role, should expect to face federal prosecution.”

An indictment, returned under seal by a Houston grand jury on Aug. 31, 2011, was unsealed today in U.S. District Court in Houston following the arrest of Jodi Leonore Latson, 45, of Houston. Latson is charged with one count of conspiracy to commit health care fraud, two counts of health care fraud, one count of conspiracy to pay or receive kickbacks and four counts relating to the payment and receipt of kickbacks. According to the indictment, Latson owned and operated a Medicare referral business known as Health Pro Resources LLC. The indictment alleges that Latson used a data-mining service to compile lists of Medicare beneficiaries. The lists were provided to Health Pro Resources employees who worked in a “boiler room” call-center and recruited beneficiaries through telemarketing calls. According to the indictment, Latson then provided beneficiary information to 100 different home health care agencies in exchange for illegal payments. The indictment alleges that Latson caused the submission of false and fraudulent claims to the Medicare program for home health care services that were medically unnecessary and not prescribed by a patient’s physician. According to the indictment, the Medicare program paid the companies who purchased beneficiaries from Latson approximately $61.5 million. Latson is set to appear this afternoon before U.S. Magistrate Judge Nancy Johnson.

In a separate and unrelated case, Akinsunbo Akinbile, 43, of Richmond, Texas, has been charged in a superseding indictment with eight counts of health care fraud in connection with an approximately $700,000 scheme to defraud the Medicare program through the submission of fraudulent claims for durable medical equipment (DME). Akinbile was also charged with two counts of aggravated identity theft. Akinbile was the owner of Hallco Medical Supply, a DME company in Houston. On bond since being charged in February 2011, Akinbile appeared today and has been permitted to remain on bond pending his trial.

Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,140 defendants who collectively have falsely billed the Medicare program for more than $2.9 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-Office of Inspector General (OIG), are taking steps to increase accountability and decrease the presence of fraudulent providers. The Houston Strike Force has obtained indictments of more than 71 individuals who collectively have falsely billed the Medicare program for more than $96.8 million since it began its operation in late July 2009.

The results of the nationwide takedown were announced today by Attorney General Holder, HHS Secretary Kathleen Sebelius, FBI Director Robert S. Mueller, Assistant Attorney General Lanny A. Breuer of the Criminal Division, and Inspector General Daniel R. Levinson of the HHS – OIG. The Houston indictments were announced by U.S. Attorney José Angel Moreno of the Southern District of Texas; Special Agent in Charge Stephen L. Morris of the FBI’s Houston Field Office; Special Agent in Charge Mike Fields of the Dallas Regional Office of HHS-OIG, Office of Investigations; and Texas Attorney General Greg Abbott. The investigation leading to the charges was conducted by the FBI, HHS-OIG, the Texas Attorney General’s Medicaid Fraud Control Unit, and the United States Railroad Retirement Board.

An indictment is a formal accusation of criminal conduct, not evidence.

A defendant is presumed innocent until proven guilty.”

To find additional federal criminal news, please read Federal Crimes Watch Daily.

Douglas McNabb and other members of the U.S. law firm practice and write and/or report extensively on matters involving Federal Criminal Defense, INTERPOL Red Notice Removal, International Extradition and OFAC SDN Sanctions Removal.

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

October 18, 2010

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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