Source- http://www.justice.gov/opa/pr/2013/May/13-crm-526.html
Miami residents Raymond Arias, 42, and his wife, Emelitza Arias, 25, have been sentenced in Detroit to 100 months and 12 months in prison, respectively, for their participation in a $13.3 million Medicare fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Robert D. Foley III of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Service’s Office of Inspector General’s (OIG) Chicago Regional Office, made the announcement after sentencing by U.S. District Paul D. Borman of the Eastern District of Michigan.
The Ariases were also sentenced to two years of supervised release following their respective prison terms. At sentencing on May 7, 2013, the court ordered Raymond Arias to pay $5.4 million in restitution. Today at sentencing, the court ordered Emelitza Arias to pay $531,883 in restitution, jointly and severally. The defendants agreed to forfeit approximately $40,000 seized by federal agents during the investigation.
The Ariases pleaded guilty on Oct. 17, 2012, to one count of conspiring to commit health care fraud. According to the plea documents, beginning in approximately 2009, Raymond Arias opened Elite Wellness where he submitted claims to Medicare for infusion therapy treatments that were never rendered. In three months, Elite Wellness submitted in excess of $10 million in claims to Medicare. Emelitza Arias joined the scheme by opening a second clinic, Carefirst Physical Therapy & Rehabilitation Center, which submitted approximately $940,000 in claims to Medicare for infusion therapy treatments that were never rendered.
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Source- http://www.justice.gov/usao/mn/jameshoodsentenced.html
MINNEAPOLIS—Earlier today in federal court in Minneapolis, a North Oaks couple was sentenced for committing health-care fraud, specifically making false statements to garner, county, state, and federal benefits and assistance for their disabled children. James N. Hood, age 69, was sentenced to 42 months in federal prison and ordered to pay a $200,000 fine on one count of mail fraud, one count of health care fraud, and one count of theft of public money. His wife, Cynthia Marsalis Hood, age 55, was ordered to serve three years of probation and pay a $300,000 fine on one count of mail fraud and one count of making a false statement for use in determining rights to Social Security benefits. The couple was also ordered to pay restitution in the total amount of $483,312.82 to the agencies victimized by this crime. The Hoods were charged on October 1, 2012, and pleaded guilty on October 24, 2012.
In sentencing the couple, U.S. District Court Judge Joan N. Ericksen reiterated that this was not a victimless crime. She said these programs were meant for people in financial need, and because of the wrongdoing of the Hoods and other fraudsters, these programs could become at risk. She also said that the couple clearly knew right from wrong and took this action for their own personal gain.
Following today’s sentencing, Daniel Seymour, Resident Agent in Charge of the Social Security Administration-Office of Inspector General’s (“SSA-OIG”) St. Paul Office, said, “SSA-OIG worked with federal, state, and local law enforcement partners to bring the investigation of James and Cynthia Hood to a successful conclusion. That investigation revealed that the Hoods, despite owning more than $10 million in investments, property and more, stole more than $80,000 in Supplemental Security Income (“SSI”) payments from the federal government. SSI provides a base-level, safety net income for uninsured aged, blind, or disabled individuals with very limited income or resources. The successful prosecution of this case demonstrates what can be accomplished when law enforcement partners work together to combat fraud, waste, and abuse of taxpayer dollars. SSA-OIG is gratified to see this case brought to justice, and is committed to continuing to protect SSA programs from fraud.”
The court documents on file in this case provide that during a five-year period, from January 2006 to April 2011, the couple stole approximately $400,000 in state and federal Medicaid money in addition to the $80,000 in Social Security benefits noted above. To that end, James Hood prepared false federal income tax returns that Cynthia Hood joined him in signing. Those returns were the basis of subsequent benefit applications. In addition, the couple offered false information in the benefit applications themselves, during related in-person interviews, and through income-update forms.
“Our publicly funded programs are meant to serve those in need and every dollar stolen is a dollar taken from a struggling family. Today’s sentencings send a clear message that fraud, waste, and abuse of public funds is not a victimless crime and will not be tolerated in Minnesota,” said Minnesota Department of Human Services Inspector General Jerry Kerber. “Today’s sentencings are the result of an on-going collaborative effort between federal, state, and county governments to fight fraud and abuse in health care and together we will continue to enforce the integrity of public programs.”
Following Hurricane Katrina in 2005, the Hood family, residents of New Orleans at the time, visited several states and eventually decided that Minnesota provided a high quality of life and the best health care and educational resources for their disabled children. After they moved to Minnesota, they applied for a variety of aid on behalf of those children, including, but not limited to federal Social Security supplemental income benefits, State Medical Assistance, Cost-Effective Health Insurance, and Community Alternatives for Disabled Individuals. They also obtained medical insurance assistance from Louisiana.
Eligibility for many benefit programs is based on the applicant’s disabilities and, for children, the parents’ income and resources as well as their financial contributions. To receive Social Security Supplemental Security Income benefits, for example, a single applicant cannot own more than $2,000 in income and assets, excluding a house and vehicle. To secure benefits for themselves, the Hoods falsified government documents and lied to government officials.
Lamont Pugh III, Special Agent in Charge of the U.S. Department of Health and Human Services-Office of Inspector General for the region that includes Minnesota, said of the case, “The Hoods seem to have forgotten that Medicaid exists for the country’s most needy citizens, not to enrich those who have achieved financial security. We will continue to work with our federal, state, and local law enforcement partners to ensure that these health care dollars are protected, and criminals who would defraud taxpayers are held accountable.”
During all times relevant to this case, James Hood was the sole heir to family estates and held substantial stock in AT&T, General Electric, and Exxon Mobil, among other companies. His dividend income totaled as much as $156,000 in a given year. He also maintained more than 65 bank accounts, which netted up to $183,000 in interest income annually. Moreover, he owned Iowa farmland and received farm-related payments from the U.S. Department of Agriculture’s Farm Service Agency as well as the State of Iowa. In 2005, the farm yielded Hood income of $187,910.98, but no farm-related values or incomes were reported in his benefit applications or income updates. Likewise, he failed to disclose significant financial gifts received from family trusts. During much of this time, James Hood also served as a professor at Tulane University.
Yet, in 2005, the couple applied for Medical Assistance and, in their application, listed only James Hood’s teaching salary and a small amount of dividend income. Moreover, when they applied for health insurance assistance, they failed to disclose that they were simultaneously seeking and receiving insurance assistance from the State of Louisiana.
In addition, Cynthia Hood repeatedly made false statements to the SSA in support of her children’s continued eligibility for Social Security Supplemental Security Income. Specifically, in 2006, she stated that her husband lived in Louisiana. She falsely reported that she did not own any homes, vehicles, stocks, bonds, or property. And she reported that she only had one bank account with a balance of $1,400. In fact, at the time, Cynthia Hood held at least 16 bank accounts jointly with James Hood. Later, she reported to the SSA that her Minnesota household only consisted of herself and her three children, claiming her husband lived in Iowa. In truth, her husband was living with her and financially supported the household.
In 2007, the couple submitted a renewal application with the Minnesota Health Care Program, which stated that James Hood was on unpaid leave from Tulane. In that document, the only income indicated was the children’s Social Security disability benefits. Similar statements were also made thereafter.
Ramsey County Attorney John Choi said, “I am grateful for the hard work that my staff put into investigating and confirming the facts of this case prior to handing it onto the U.S. Attorney’s Office. We take fraud very seriously and are especially thankful for the cooperative working relationship with the (Minnesota) Department of Human Services in this investigation.”
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Source- http://www.justice.gov/usao/nj/Press/files/Breihof,%20Peter%20et%20al%20Pleas%20News%20Release.html
NEWARK, N.J. – Two former sales representatives of Biodiagnostic Laboratory Services LLC (BLS) admitted today to conspiring with others to bribe doctors to refer patient blood samples to BLS, U.S. Attorney Paul J. Fishman announced.
Peter Breihof, 42, of Nutley, N.J., and William Dailey, 41, of Wall, N.J., both pleaded guilty before U.S. District Judge Stanley R. Chesler to Informations charging them with conspiracy to violate the Anti-Kickback Statute and the Federal Travel Act.
According to documents filed in this case and statements made in court:
On April 9, 2013, federal agents arrested BLS president and part-owner, David Nicoll, 39, of Mountain Lakes, N.J.; Scott Nicoll, 32, of Wayne, N.J., a senior BLS employee and David Nicoll’s brother; and Craig Nordman, 34, of Whippany, N.J., a BLS employee and the CEO of Advantech Sales LLC – an entity allegedly used by BLS to make illegal payments. They were charged with participating in a long-running scheme to bribe doctors to refer patient blood samples to BLS and order unnecessary tests, resulting in tens of millions of dollars in profit for the company. The Complaint noted that two former BLS employees – Breihof and Dailey – had agreed to plead guilty and had cooperated in the investigation.
Between 2006 and 2013, BLS, headquartered in Parsippany, N.J., and entities it funded paid millions of dollars to physicians to induce them to refer patient blood samples to BLS. From these referrals, BLS received tens of millions of dollars from private health insurance companies and Medicare. Numerous physicians were bribed under the guise of lease, service, and/or consulting agreements. Under the lease and service agreements, between 2006 and 2009, physicians were frequently paid thousands of dollars a month by BLS for space in medical offices that BLS did not need or actually use and to perform routine blood drawing services that had little real dollar value. Breihof and Dailey admitted today to using phony lease and service agreements to bribe physicians to send their patients’ blood samples to BLS. Breihof and Dailey also admitted that they paid various physicians a fee per test on behalf of BLS in order to induce those physicians to order more of the blood tests than they otherwise would have.
Breihof and Dailey each face a maximum potential penalty of five years in prison. Each count also carries a maximum $250,000 fine, or twice the gross gain or loss from the offense. In addition, Breihof has agreed to forfeit $1,179,556, and Dailey has agreed to forfeit $558,405. Sentencing for both defendants is scheduled for Sept. 19, 2013.
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Source- http://www.justice.gov/usao/pam/news/2013/AdvantageMedicalTransportInc_05_01_2013.htm
The United States Attorney’s Office for the Middle District of Pennsylvania announced today that a Harrisburg-based ambulance company has pleaded guilty to multiple False Statement charges related to Medicare fraud.
Advantage Medical Transport, Inc, headquartered at 733 Fire House Lane, Harrisburg, pleaded guilty before U.S. District Court Judge Christopher C. Conner today to 14 Counts of False Statements in Health Care Matters, 18 USC 1035. Each Count is punishable by up to as much as a $500,000 fine. Serge Sivchuk, age 27, the sole owner of Advantage, appeared in court and entered the guilty pleas on behalf of the Corporation. The Government estimated the total loss to Medicare as a result of the fraud was approximately $740,000.
According to U.S. Attorney Peter J. Smith, Sivchuk and Advantage were indicted in January 2012 on multiple False Statement and Medicare Fraud charges. The Indictment alleged that between January of 2009 and June of 2011 Sivchuk and Advantage perpetrated a scheme to defraud Medicare by submitting hundreds of claims for the nonemergency transport of Medicare beneficiaries to and from dialysis treatment centers. The Indictment alleged the claims were fraudulent because the patients were ambulatory and the ambulance transports were not medically necessary.
The Indictment focused on an August 2010 audit conducted by Medicare and a June 2, 2011 search of Advantage’s business premises by federal law enforcement officers. In response to the audit Sivchuk submitted 14 ambulance Trip Sheets to Medicare that were prepared by Emergency Medical Technicians (EMTs) at the time of each ambulance transport. The Trip Sheets contained a narrative section that described the patient’s physical condition and ability to ambulate, and serve as the primary support document for each Medicare billed, ambulance transport claim. The June 2, 2011 search by the FBI and investigators from the Health and Human Services (HHS) Inspector General’s Office revealed Sivchuk did not submit the original trip sheets to the auditors but instead submitted copies that had been re-written and forged to conceal the fact the beneficiaries were ambulatory and capable of walking and standing.
During a February 22, 2013 court appearance before Judge Connor, Sivchuk plead guilty to one of the 14 False Statement Counts for which he was indicted, admitting he directed a subordinate to re-write and forge the signatures of two EMTs on a Trip Sheet pertaining to the ambulance transport of a dialysis treatment beneficiary on August 19, 2010. Sivchuk is currently awaiting sentencing and the completion of a pre-sentence report.
Medicare paid Advantage approximately $166 for each leg of a transport to and from a dialysis treatment center, plus $5.49 per mile. Many dialysis patients underwent 3 treatments per week. Thus, one week’s transport of just one dialysis patient would yield Advantage more than $1,000.
Under the terms of Advantage’s plea agreement Judge Conner will determine the overall loss to Medicare. During the guilty plea proceeding Assistant U.S. Attorney Kim Douglas Daniel told the Court the government intends to show during the loss hearing that the total loss to Medicare was approximately $740,000. Daniel also noted that at the time the investigators executed the June 2, 2011 search warrant, the U.S. Attorney’s Office filed a civil action in federal court that froze more than $936,000 in Advantage and Sivchuk controlled bank accounts.
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Source- http://www.justice.gov/usao/ks/PressReleases/2013/May2013/May1a.html
TOPEKA, KAN. – A grand jury has returned an indictment charging a physician in Manhattan, Kan., with unlawfully distributing prescription drugs, U.S. Attorney Barry Grissom said today.
Physician Michael Schuster, 53, who operates Manhattan Pain and Spine in Manhattan, Kan., is charged with four counts: One count of conspiracy to illegally distribute controlled substances, one count of unlawful distribution of controlled substances, one count of unlawfully distributing controlled substances to a person under 21 years old and one count of maintaining a premises in furtherance of unlawful drug distribution.
The indictment alleges that Schuster employed unlicensed staff members who distributed controlled substances to patients using Schuster’s signature on prescriptions while he was traveling out of the state or out of the country. Schuster was out of the office when a total of 540 patients received prescriptions for medications including oxycodone, morphine, hydromorphone, methadone, oxymorphone, tapentadol, fentanyl, amphetamine, methylphenidate, hydrocodone, alprazolam, clonazepam, diazepam and zolpidem.
Schuster initially was charged in a criminal complaint filed April 23, 2013, in U.S. District Court in Topeka. According to an investigator’s affidavit, the investigation began early in 2012 when the Riley County Police Department received reports that Schuster was issuing prescriptions for high dosages of scheduled drugs based on minimal or cursory physical examinations.
The indictment returned today states that controlled substances may be dispensed and distributed lawfully by means of a prescription that is issued for a legitimate medical purpose by a practitioner acting in the usual course of professional practice. The practitioner must be registered with the Drug Enforcement Administration. Signing a blank prescription and having unauthorized, unlicensed individuals who are not registered with the DEA distribute controlled substances is not a lawful prescription.
The indictment alleges Schuster routinely pre-signed blank prescription forms with the intent that his unlicensed staff members would use them to issue controlled substances to patients while he was not at the clinic.
Count 2 of the indictment alleges Schuster caused unlicensed staff using blank prescriptions to distribute controlled substances while he was out of the clinic at various locations including Russia, South Africa, Uruguay, Canada, New York, Chile, Argentina, Brazil and Israel.
Count 3 alleges that on June 16, 2010, Schuster caused oxycodone to be distributed to a person under the age of 21, who is identified in the indictment as Rex V.
Count 4 alleges that from April 2007 to August 2012 Schuster knowingly maintained a premises, his office at 1135 Westport Drive in Manhattan, Kan., for the purpose of unlawfully distributing controlled substances.
The indictment also seeks the forfeiture of all the proceeds from the crimes.
Upon conviction, the crimes carry the following penalties:
Conspiracy: A maximum penalty of 20 years in federal prison and a fine up to $1 million. If death or bodily injury results from the crime, the penalty is not less than 20 years.
Unlawful distribution of controlled substances: A maximum penalty of 20 years in federal prison and a fine up to $1 million. If death or bodily injury results from the crime, the penalty is not less than 20 years.
Unlawful distribution of controlled substances to a person under 21 years old: A maximum penalty of 20 years in federal prison and a fine up to $1 million. If death or bodily injury results from the crime, the penalty is not less than 20 years.
Maintaining drug involved premises: A maximum penalty of 20 years and a fine up to $500,000.
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Source- http://www.justice.gov/opa/pr/2013/May/13-civ-495.html
St. Vincent Healthcare, a hospital located in Billings, Mont., and Holy Rosary Healthcare, a hospital located in Miles City, Mont., have agreed to pay $3.95 million plus interest to resolve allegations that they violated the Stark Law and the False Claims Act by improperly providing incentive pay to physicians that made referrals to the hospitals, the Justice Department announced today.
The Stark Law forbids a hospital from billing Medicare for certain services referred by physicians who have a financial relationship with the hospital unless that relationship falls within certain exceptions. A prohibited financial relationship includes a hospital’s agreement to compensate a physician in a manner that takes into account the volume of the physician’s referrals or the revenue realized through those referrals.
The settlement announced today resolves allegations that the hospitals paid several physicians incentive compensation that took into account the value or volume of their referrals by improperly including certain designated health services in the formula for calculating physician incentive compensation. These issues were disclosed by the hospitals to the government.
“The resolution of this matter underscores our commitment to ensure that services reimbursable by federal health care programs are based on the best interests of patients rather than the personal financial interests of referring physicians,” said Stuart F. Delery, Acting Assistant Attorney General for the Department’s Civil Division.
“Combating health care fraud is a top priority of the Department of Justice and the Montana U.S. Attorney’s Office. St. Vincent Healthcare and Holy Rosary Healthcare allegedly put their financial interest ahead of their responsibility to provide cost effective health care. The United States recovered $3,950,000 of taxpayers’ dollars from the hospitals. The U.S. Attorney’s Office is committed to enforcing the Stark Law and False Claims Act, as well as other health care laws and regulations against wrongdoers. This case also demonstrates how the Department of Justice will work with those health care providers who disclose their misconduct,” said Michael W. Cotter, U.S. Attorney for the District of Montana.
“There is an expectation that corporations providing services to Medicare and Medicaid beneficiaries adhere to the provision of the Stark Law. I applaud St. Vincent Healthcare and Holy Rosary Healthcare for recognizing their potential liability in this matter and making a disclosure,” said Gerry Roy, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services region including Montana. “Working closely with our partners at the Department of Justice, we will vigilantly protect federal health care programs against violations of the Stark Law.”
This resolution is part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services, in May 2009. The partnership between the two departments has focused on efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover $10.3 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are over $14.2 billion.
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Source- http://www.justice.gov/usao/can/news/2013/2013_04_30_crihb.settles.press.html
SAN FRANCISCO - The California Rural Indian Health Board Inc. (“CRIHB”), a nontribal entity and grantee of the U.S. Department of Health and Human Services (“HHS”), Substance Abuse and Mental Health Services Administration (“SAMHSA”), agreed to pay the United States $532,000, and to be terminated from an existing SAMHSA grant, thereby relinquishing funds valued at over $4.6 million, announced United States Attorney Melinda Haag. In addition, CRIHB will be subject to certain administrative conditions imposed by SAMHSA, and will not be eligible to apply for any new SAMHSA funding opportunities for two federal fiscal years.
The settlement resolves a lawsuit filed against CRIHB in July 2012 by the U.S. Attorney’s Office under the federal False Claims Act, 31 U.S.C. §§ 3729-33. The United States alleged that CRIHB submitted false claims by, among other things, eliminating the substance abuse screening and assessment required of certain Access to Recovery (“ATR”) program applicants, and instructing ATR service providers to pay for prohibited expenses, such as the clients’ rent, mortgage, utilities, and auto repairs. The lawsuit further alleged that CRIHB instructed the ATR service providers to bypass voucher rules, all contrary to the terms of the ATR grant and HHS regulations.
“This settlement is a victory for all ATR clients who need substance and alcohol abuse treatment and recovery support. It sends a clear message that my office is committed to ensuring that federal grant funds are used for their intended purpose.” U.S. Attorney Haag said.
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Source- http://www.justice.gov/usao/gas/press_releases/2013/20130426_Moskovian.html
BRUNSWICK, GA: AVETIK MOSKOVIAN, 46, an Armenian National, plead guilty Tuesday before Chief United States District Court Judge Lisa Godbey Wood to his role in a conspiracy launder approximately $1.5 million in funds defrauded from Medicare through a phony medical business in Brunswick, Georgia.
MOSKOVIAN, who resided in Los Angeles until the time of his arrest and was here in the United States on a permanent residence card from Armenia, pleaded guilty to Money Laundering Conspiracy in violation of Title 18, United State Code, Section 1956(h), before Chief United States District Court Judge Lisa Godbey Wood.
According to the evidence presented at MOSKOVIAN’S guilty plea hearing:
From 2007 through 2008, various conspirators defrauded Medicare through a durable medical equipment company in Brunswick, Georgia, known as Brunswick Medical Supply. These conspirators submitted millions of dollars in phony claims for health care services that were never provided. The evidence showed that the conspirators stole the identities for doctors and patients from multiple different states, including Alaska, California, New York, and Ohio, and even submitted claims for people that were deceased at the time that he claimed to have provided them the medical equipment.
Once Medicare paid for these phony claims, MOSKOVIAN and other took numerous steps to launder the stolen money. MOSKOVIAN helped form at least four sham businesses in Los Angeles, opened multiple bank accounts in the names of these businesses, and used these bank accounts to launder the proceeds of the fraud at Brunswick Medical Supply. MOSKOVIAN engaged in multiple financial transactions within these accounts, including wire transfers and counter withdrawals of tens of thousands of dollars in cash, as part of his effort to help hide the money defrauded from Medicare.
MOSKOVIAN now faces a maximum statutory penalty of up to twenty (20) years in prison; a fine up to $500,000; and 5 years of supervised release. His sentencing will be scheduled after the United States Probation Office completes a presentence investigation.
United States Attorney Edward J. Tarver said, “Moskovian and others in this criminal organization thought that they could exploit Medicare to steal from this nation’s taxpayers and then avoid detection through this defendant’s money laundering operations. They were wrong. With this money laundering conviction, this Office and its law enforcement partners have taken another important step towards cleaning up the fraud in our nation’s health care programs.”
Derrick L. Jackson, Special Agent in Charge of the Atlanta Region for the Office of Inspector General of the Department of Health and Human Services, said “Avetik Moskovian engaged in a scheme to defraud Medicare by conducting numerous financial transactions with money that was generated through unlawful activity. The OIG strongly pursues those who abuse government healthcare programs for financial gain.”
Mark F. Giuliano, Special Agent in Charge, FBI Atlanta Field Office, stated: “The FBI remains very committed toward providing the much needed investigative resources in protecting such federally funded programs like Medicare from fraud and abuse. Mr. Moskovian, in diverting those public funds to his personal bank account, denied other individuals the health care that those funds were intended for.”
The prosecution of MOSKOVIAN was part of a multi-jurisdictional investigation involving more than $100 million worth of phony claims submitted to Medicare. More than 35 defendants were charged as part of this investigation in Brunswick, Georgia, New York, Los Angeles, Cleveland and Albuquerque. The investigation in the Southern District of Georgia was the result of a multi-agency team of federal, state and local agents, led by the FBI and HHS-OIG), working together to combat health care fraud.
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Source- http://www.justice.gov/opa/pr/2013/April/13-crm-475.html
A federal jury today convicted a Miami-area supervisor of a mental health care company, Health Care Solutions Network (HCSN), for helping to orchestrate a fraud scheme that crossed state lines and that resulted in the submission of more than $63 million in fraudulent claims to Medicare and Florida Medicaid.
The announcement was made by Acting Assistant Attorney General Mythili Raman of the Justice Department's Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Michael B. Steinbach, Special Agent in Charge of the FBI's Miami Field Office; and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigation’s Miami office.
After a five-day trial, a jury in the Southern District of Florida found Wondera Eason, 51, guilty of conspiracy to commit health care fraud. Sentencing is scheduled for July 8, 2013.
Eason was employed as the Director of Medical Records at HCSN’s Partial Hospitalization Program (PHP). A PHP is a form of intensive treatment for severe mental illness. In Florida, HCSN operated community mental health centers at two locations. After stealing millions from Medicare and Medicaid in Florida, HCSN’s owner, Armando Gonzalez, exported the scheme to North Carolina, opening a third HCSN location in Hendersonville.
Evidence at trial showed that at all three locations, Eason, a certified medical records technician, oversaw the alteration, fabrication, and forgery of thousands of documents, which purported to support the fraudulent claims HCSN submitted to Medicare and Florida Medicaid. Many of these medical records were created weeks or months after the patients were admitted to HCSN facilities in Florida for purported PHP treatment and were utilized to support false and fraudulent billing to government sponsored health care benefit programs, including Medicare and Florida Medicaid. Eason directed therapists to fabricate documents, and she also forged the signature of therapists and others on documents that she was in charge of maintaining. Eason interacted with Medicare and Medicaid auditors, providing them with false and fraudulent documents, while certifying the documents were accurate.
The “therapy” at HCSN oftentimes consisted of nothing more than patients watching Disney movies, playing bingo and having barbeques. Eason directed therapists to remove any references to these recreational activities in the medical records.
According to evidence at trial, Eason was aware that HCSN in Florida paid illegal kickbacks to owners and operators of Miami-Dade County Assisted Living Facilities (ALF) in exchange for patient referral information to be used to submit false and fraudulent claims to Medicare and Medicaid. Eason also knew that many of the ALF referral patients were ineligible for PHP services because many patients suffered from mental retardation, dementia and Alzheimer's disease.
From 2004 through 2011, HCSN billed Medicare and the Florida Medicaid program approximately $63 million for purported mental health services.
Fifteen defendants have been charged for their alleged roles in the HCSN health care fraud scheme, and 12 defendants have pleaded guilty. On Monday, Feb. 25, 2013, Gonzalez was sentenced to serve 168 months in prison for his role in the scheme. Alleged co-conspirators Alina Feas and Lisset Palmero are scheduled for trial on June 3, 2013. Defendants are presumed innocent until proven guilty at trial.
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Source- http://www.justice.gov/opa/pr/2013/April/13-crm-471.html
A Southern California physician, a durable medical equipment (DME) supply company employee and a health care professional were found guilty late yesterday by a federal jury in Los Angeles for their roles in a $1.5 million Medicare fraud scheme, announced Acting Assistant Attorney General Mythili Raman of the Criminal Division; U.S. Attorney for the Central District of California André Birotte Jr.; Bill L. Lewis, Assistant Director in Charge of the FBI’s Los Angeles Field Office; and Glenn R. Ferry, Special Agent in Charge of the Los Angeles Region of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).
Godwin Onyeabor, 49, of Ontario, Calif., Sri J. Wijegunaratne, 58, of Anaheim, Calif., and Heidi Morishita, 48, of Valencia, Calif., were each found guilty in U.S. District Court in the Central District of California of one count of conspiracy to pay and receive kickbacks. Wijegunaratne was also found guilty of conspiracy to commit health care fraud and six substantive counts of health care fraud. Onyeabor was also found guilty of conspiracy to commit health care fraud and 11 substantive counts of health care fraud.
The trial evidence showed that between January 2007 and February 2012, Onyeabor, an officer at Fendih Medical Supply Inc., a DME supply company located in San Bernadino, Calif., and others paid cash kickbacks to Wijegunaratne, a physician, and Morishita for fraudulent prescriptions for DME, including power wheelchairs. The evidence showed that Wijegunaratne wrote prescriptions for power wheelchairs and other DME that Medicare beneficiaries did not need and sometimes never used. After receiving prescriptions from Wijegunaratne and Morishita, Onyeabor and others used the prescriptions to fraudulently bill Medicare for the medically unnecessary DME.
At trial, several Medicare beneficiaries testified that they were lured to medical clinics with the promise of free items such as vitamins and juice, only to receive power wheelchairs that they did not need and did not want. The beneficiaries further testified that their attempts to reject delivery of the power wheelchairs from Onyeabor’s supply company were unsuccessful.
As a result of this fraud scheme, Onyeabor, Wijegunaratne and others submitted and caused the submission of approximately $1.5 million in false and fraudulent claims to Medicare, and received almost $1 million on those claims.
At sentencing, scheduled for Sept. 9, 2013, Onyeabor, Wijegunaratne and Morishita face a maximum penalty of 10 years in prison and a $250,000 fine for each count.
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Source- http://www.justice.gov/usao/ncw/pressreleases/2013/Charlotte-2013-04-25-curte.html
CHARLOTTE, N.C. – The former owner of Wilkesboro Clinical Laboratory (“WCL”) pleaded guilty today in U.S. District Court for his involvement in a health care fraud scheme in which he and his company billed Medicare for services which were not rendered, announced Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina. Louis Francis Curte, 49, also admitted he filed false tax returns from 2007 to 2010.
In a separate civil settlement with the U.S. Attorney’s Office, Curte also agreed to pay $300,000 to resolve civil fraud allegations that he and his company violated the Physician Self-Referral Act or “Stark Law.”
U.S. Attorney Tompkins is joined in making today’s announcement by Derrick Jackson, Special Agent in Charge, Department of Health and Human Services, Office of the Inspector General (HHS-OIG), Office of Investigations, Atlanta Region; Jeannine A. Hammett, Special Agent in Charge of the Internal Revenue Service, Criminal Investigation Division (IRS-CI); and John A. Strong, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division.
Curte appeared before U.S. Magistrate Judge David C. Keesler today and pleaded guilty to four counts of health care fraud and one count of filing a false tax return. According to court documents and today’s plea hearing, Curte was the owner and operator of Wilkesboro Clinical Laboratory (“WCL”), which was enrolled with the Medicare program and provided microbiology and other laboratory services. Court records show that from at least 2007 to in or about 2009, Curte defrauded Medicare by submitting false and fraudulent claims for microbiology services which were never rendered.
Court documents indicate that Curte and WCL used another company (“Company #1”) for certain types of microbiology testing that could not be performed by WCL in-house. Court records show that WCL generally submitted specimens to Company #1 to test for the presence of infection-causing bacteria. If an infection was present in a specimen, Company #1 then typically performed one or two additional tests to identify the type of pathogen present (“identification test”) and the type of antibiotic to which the pathogen was susceptible (“susceptibility test”).
Pursuant to the scheme to defraud, Curte routinely billed Medicare for identification and susceptibility tests, when, in fact, no such tests were performed and even when the initial testing indicated that no pathogen was actually present in the specimen. According to the plea agreement, the intended loss to Medicare by the defendant was between $10,000 and $30,000.
At today’s hearing, Curte also pleaded guilty to filing false tax returns for the years 2007 through 2010. According to filed documents and court proceedings, Curte filed false tax returns which substantially understated his gross income, and therefore, the tax owed to the United States. Court records indicate that Curte maintained false books in an attempt to mask a prohibited business relationship with a physician, identified in court documents as Dr. T.M. According to the plea agreement, the amount of tax loss was more than $30,000 but less than $50,000.
At sentencing, Curte faces a maximum term of 10 years in prison and a $250,000 fine for the health care fraud charges and a maximum term of three years in prison and a $250,000 fine for the tax fraud charge. In his plea agreement, Curte agreed to pay full restitution to Medicare and to IRS for any losses. The final restitution amount will be determined by the Court at Curte’s sentencing hearing, which has not been scheduled yet. Curte has been released on bond pending sentencing.
Curte’s prohibited relationship with Dr. T. M. forms the basis for Curte’s civil settlement agreement. According to the civil settlement agreement, from January l, 2006 through April 30, 2009 Curte and WCL violated the Stark Law by knowingly having a prohibited financial relationship with Dr. T.M.
Dr. T.M. owned and operated a billing company, now defunct, which submitted all of WCL’s reimbursement claims to Medicare. Dr. T.M.’s billing company was paid on a “per claim” basis for the reimbursement claims submitted to Medicare on behalf of WCL. As an owner of the billing company, Dr. T.M. benefitted directly from WCL’s payments to his billing company. Investigators also found that Dr. T.M. referred blood and tissue specimens to WCL for pathology testing.
The Stark Law forbids a medical provider from billing Medicare and Medicaid for certain services referred by physicians who have a financial relationship with the medical provider. A prohibited financial relationship includes an agreement between the medical provider and a physician to compensate the physician based on the volume of the physician’s referrals or the revenue realized through those referrals.
Under the terms of the settlement agreement, Curte is required to reimburse the government for the amount he wrongfully received from Medicare in violation of the Stark Law and to pay penalties back to the program, for a total of $300,000.
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Source- http://www.justice.gov/opa/pr/2013/April/13-crm-467.html
An employee of Detroit medical service companies that fabricated patient visit notes and other documents as part of a $24 million home health care fraud scheme pleaded guilty today for her role in the conspiracy, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade, Special Agent in Charge Robert D. Foley III of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Chicago Regional Office.
Dana Sharma, 30, of Detroit, pleaded guilty before U.S. District Judge Denise Hood in the Eastern District of Michigan to one count of conspiracy to commit health care fraud.
According to court documents, Sharma worked at purported home health companies, including First Choice Home Health Care Services Inc. and Reliance Home Care LLC, where she and other conspirators agreed to submit false and fraudulent claims to Medicare for home health services. Court documents reveal that, among other things, Sharma organized and maintained company patient files, knowing that these files contained falsified patient visit notes that created the false impression that home health care had been provided to patients. Sharma admitted that she knew that these documents would be used by these companies to submit claims to Medicare for home health services that were not medically necessary and/or not provided.
Court documents allege that between January 2007 and May 2012, Sharma’s conduct caused home health companies to submit claims to Medicare for services that were not medically necessary and/or not provided, which in turn caused Medicare to pay these companies approximately $923,286.
At sentencing, scheduled for Aug. 1, 2013, Sharma faces a maximum penalty of 10 years in prison and a $250,000 fine.
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Source- http://www.justice.gov/usao/txe/News/2013/edtx-hcf-mahmood-042313.html
TYLER, Texas – A Dallas County, Texas, physician has been arrested and charged with health care fraud violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales today.
Tariq Mahmood, 61, of Cedar Hill, Texas, was indicted by a federal grand jury on April 11, 2013, and charged with conspiracy to commit health care fraud and seven counts of health care fraud. Mahmood went before U.S. Magistrate Judge John D. Love today for an initial appearance.
According to the indictment, Mahmood, a general practitioner, owned and operated several hospitals in the state of Texas, including Cozby Germany Hospital in Grand Saline, Renaissance Terrell Hospital in Terrell, Central Texas Hospital in Cameron, Community General Hospital in Dilley, and Shelby Regional Medical Center in Center. From April 2010 to April 2013, Mahmood and others are alleged to have carried out a scheme to defraud Medicare and Medicaid through the submission of false and fraudulent claims. Mahmood and others added, changed, deleted, and incorrectly sequenced diagnostic codes in a way that did not reflect the actual diagnoses and conditions of the patients. They submitted false and fraudulent claims to Medicare and Medicaid based on the added, changed, deleted, and incorrectly sequenced diagnostic codes. By means of fraudulent billing practices, the defendant and his co-conspirators are alleged to have unlawfully submitted false claims of more than $1.1 million and obtained more than $375,000.
If convicted, Mahmood faces up to 10 years in federal prison for each charge.
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Source- http://www.justice.gov/usao/dc/news/2013/apr/13-141.html
WASHINGTON – Tina Jackson-White, the owner and president of Family Home Medical Equipment and Supplies, LLC, pled guilty today to a federal charge of health care fraud stemming from a scheme in which the firm submitted and collected more than $200,000 in fraudulent Medicaid claims.
The guilty plea was announced by U.S. Attorney Ronald C. Machen Jr.; Valerie Parlave, Assistant Director in Charge of the FBI’s Washington Field Office; Nicholas DiGiulio, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS - OIG) for the region including the District of Columbia, and Charles J. Willoughby, District of Columbia Inspector General.
Jackson-White, 51, of Bowie, Md., pled guilty in the U.S. District Court for the District of Columbia. The Honorable Amy Berman Jackson scheduled sentencing for July 9, 2013. Jackson-White faces a statutory maximum of 10 years in prison and financial penalties. Under federal sentencing guidelines, the parties have agreed that she faces a likely range of 24 to 30 months of incarceration and a fine of up to $50,000. As part of her plea agreement, Jackson-White has agreed to pay $212,893 in restitution to the District of Columbia Medicaid program.
According to a statement of offense, signed by the defendant as well as the government, Family Home Medical Equipment and Supplies provided durable medical equipment, or DME, such as adult incontinence supplies and other medical products to Medicaid beneficiaries in the District of Columbia and Maryland. Under Medicaid rules, the company would pay for the cost of the products supplied to beneficiaries and then submit claims for reimbursement.
Between January 2007 and December 2011, the company billed D.C. Medicaid for a total of $212,893 in fraudulent claims. The claims, knowingly submitted by the defendant, were for incontinence products, such as briefs, diapers and liners, which were not actually provided.
“Medicaid is designed to provide low-income families and people with disabilities with access to critical health care,” said U.S. Attorney Machen. “Over five years, this business owner defrauded the Medicaid program by submitting bills for more than $200,000 in supplies that were never delivered. This prosecution illustrates our commitment to fighting the fraud that undermines the integrity of federal health care programs and diverts resources intended to serve our neighbors in need.”
“Instead of providing medical supplies to citizens in the District of Columbia and Maryland, Ms. Jackson-White intentionally manipulated our Medicaid system and pocketed the money from claims she submitted,” said Assistant Director in Charge Parlave. “Along with our partners at HHS-OIF and DC-OIG, the FBI will continue to pursue all such fraudulent schemes which damage the ability of health care providers, employers and patients to participate in a system free of fraud and dishonesty.”
“As demands on the D.C. Medicaid program increase even as resources remain scarce, fraud is less tolerable than ever”, said HHS-OIG Special Agent in Charge DiGiulio. “Criminals such as Jackson-White will be brought to justice through aggressive investigation and prosecution.”
“This matter again represents how the District can work together with its federal colleagues in law enforcement to protect the interests of its citizenry and the public treasury,” said Inspector General Willoughby.
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Hugh Marion Willett, the owner of two Texas-based durable medical equipment companies, was sentenced today to 41 months in prison, followed by three years of supervised release, and ordered to pay $182,450 in restitution, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division.
Willett, 69, of Fort Worth, Texas, was found guilty in January by U.S. District Judge Jane J. Boyle in the Northern District of Texas on all seven counts of a June 2012 second superseding indictment: one count of conspiracy to commit health care fraud and six counts of health care fraud stemming from a durable medical equipment (DME) fraud scheme. His wife, Jean Willett, previously pleaded guilty to the same charges and was sentenced in September 2012 to 50 months in prison.
The evidence at trial showed that between 2006 and 2010, the Willets co-owned and operated JS&H Orthopedic Supply LLC and Texas Orthotic and Prosthetic Systems Inc., which claimed to provide orthotics and other DME to beneficiaries of Medicare and private insurance benefit programs including Aetna, Blue Cross Blue Shield and CIGNA.
Evidence presented in court proved that both of these companies intentionally submitted claims to Medicare and other insurers for products that were materially different from and more expensive than what was actually provided, and that Hugh Marion Willett was a knowing and willful participant in the fraud.
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United States Attorney Anne M. Tompkins Western District of North Carolina
CHARLOTTE, N.C. – A Charlotte neurologist has agreed to pay $2 million plus interest to the United States to settle civil fraud allegations, announced Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina. Hemanth P. Rao, MD, is the owner of and principal neurologist at The Neurological Institute in Charlotte, formerly known as Neurological Consultants of the Carolinas.
U.S. Attorney Tompkins is joined in making today’s announcement by Derrick Jackson, Special Agent in Charge, Department of Health and Human Services, Office of the Inspector General (HHS-OIG), Office of Investigations, Atlanta Region.
The settlement was reached following a multi-year investigation by HHS-OIG into Dr. Rao’s practices associated with the administration of intravenous immunoglobulin (IVIG) therapy. Government investigators found that from October 13, 2003 to May 26, 2006, Dr. Rao failed to meet the Medicare supervision regulations associated with IVIG therapy. IVIG is the delivery of healthy immunoglobulins directly into the bloodstream of patients suffering from immunodeficiency and autoimmune disorders. IVIG therapy involves the injection of a thick, viscous fluid into the veins of patients throughout a period of several hours. The Medicare program requires that the patient’s physician directly supervise the administration of this treatment in order to ensure the safety of the patient. Investigators found that Dr. Rao sought and obtained reimbursement for his IVIG therapy services from Medicare even though he was not present in the building with his patients when they were receiving IVIG treatment, as required by Medicare.
The Settlement Agreement also requires that Dr. Rao pay an additional $500,000 to Medicare upon the sale of his real estate holdings. Furthermore, Dr. Rao entered into a five-year Integrity Agreement with HHS-OIG to promote compliance with the statutes, regulations, program requirements, and written directives of Medicare, Medicaid, and all other federal health care programs.
In making today’s announcement U.S. Attorney Tompkins stated, “Dr. Rao’s actions not only compromised the integrity of the Medicare program, but exposed his patients to potential danger. I commend HHS-OIG for their thorough investigation and for their continued efforts to protect Medicare, an important health care program seniors rely upon to cover their health care needs.”
“Dr. Rao allowed his staff to practice a potentially hazardous procedure on Medicare patients, without his supervision, then blatantly charge taxpayers,” said Derrick Jackson of the HHS-OIG region including North Carolina. “Citizens of this State can continue to look toward U.S. Attorney Tompkins to vigorously pursue providers who shortcut Medicare regulations in exchange for profit.”
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Source- http://www.justice.gov/usao/iln/pr/chicago/2013/pr0418_02.html
CHICAGO — A Chicago physician associated with Sacred Heart Hospital on the city’s west side is facing federal charges for allegedly illegally prescribing hydrocodone to a hospital patient without having a valid license and registration to prescribe controlled substances. The defendant, Dr. KENNETH S. NAVE, allegedly illegally used the Drug Enforcement Administration registration number of another physician when he prescribed the hydrocodone last December.
Nave, 50, of Chicago, was arrested yesterday in Miami when he returned from a trip outside the country. He appeared today in Federal Court in Miami, was released, and ordered to appear at 3 p.m. tomorrow before U.S. Magistrate Judge Daniel G. Martin in U.S. District Court in Chicago. He was charged in a criminal complaint that was filed on Monday and unsealed upon his arrest.
Also today, the Illinois Department of Financial and Professional Regulation issued an order suspending Nave’s license to practice medicine.
On Tuesday, the owner and chief executive officer of Sacred Heart was arrested, along with the hospital’s chief financial officer and four physicians affiliated with the hospital on federal charges alleging a conspiracy to pay and receive kickbacks in exchange for referral of Medicare and Medicaid patients to the hospital. Federal agents also executed search and seizure warrants as part of an ongoing investigation of Medicare fraud allegations involving medically unnecessary emergency room admissions and in-patient tracheotomy procedures.
According to the complaint against Nave, who is the fifth physician to be charged, the investigation has revealed that between at least November 2012 and Feb. 25, 2013, he issued prescriptions to patients at Sacred Heart for controlled substances using the DEA registration issued to Physician I. On Dec. 7, 2012, Nave allegedly prescribed a particular patient 90 pills containing hydrocodone, a narcotic controlled substance, using Physician I’s registration number.
Nave’s Illinois license to practice medicine was suspended between 2002 and 2008. It was restored to probationary status on Dec. 20, 2012, but his state license to prescribe controlled substances was not restored until Feb. 26, 2013, according to the complaint affidavit. Separately, Nave was not registered with the DEA to prescribe controlled substances but an application for DEA registration that was submitted on March 6, 2013, is pending, the affidavit adds.
The affidavit cites records from the Centers for Medicare and Medicaid Services indicating that between Nov. 1, 2012, and Feb. 25, 2013, a person using Physician I’s name and DEA registration number issued approximately 101 prescriptions for controlled substances to approximately 33 patients at Sacred Heart Hospital.
The illegal prescription count carries a maximum penalty of four years in prison and a $250,000 fine. If convicted, the Court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines.
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Source- http://www.justice.gov/opa/pr/2013/April/13-crm-443.html
A federal jury in Detroit today convicted the office manager of a home health agency for her participation in a $5.8 million Medicare fraud scheme, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Robert D. Foley III, Special Agent in Charge of the FBI Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations Detroit Office.
Nabila Mahbub, 27, the office manager of All American Home Care Inc., was found guilty in U.S. District Court for the Eastern District of Michigan of one count of conspiracy to commit health care fraud.
Mahbub was charged in a superseding indictment returned March 27, 2012. Nineteen other individuals who worked at or were associated with All American were previously convicted for their roles in the fraudulent scheme; one was acquitted at trial, but was convicted at trial for a separate, but related, scheme.
According to evidence presented at trial, the defendant and her co-conspirators caused the submission of false and fraudulent claims to Medicare through All American, a home health care company located in Oak Park, Mich., that purported to provide skilled nursing and physical therapy services to Medicare beneficiaries in the greater Detroit area.
The evidence at trial showed that the defendant and her co-conspirators used patient recruiters, who paid Medicare beneficiaries to sign blank documents for physical therapy services that were never provided and/or medically unnecessary. The owners of All American paid physicians to sign referrals and other therapy documents necessary to bill Medicare. Physical therapists and physical therapist assistants then created fake medical records using blank, pre-signed forms obtained by the patient recruiters to make it appear as if physical therapy services were actually rendered, when, in fact, they were not.
According to evidence presented at trial, Mahbub doctored and directed the doctoring of fake patient files to facilitate the commencement and billing of home health services purportedly provided by physical therapists and physical therapist assistants working for All American. Mahbub also directed the physical therapists and physical therapist assistants who created fake therapy visit notes using blank, pre-signed forms, to make it appear that physical therapy services billed to Medicare were actually provided.
All American was paid over $5.8 million from Medicare between September 2008 and November 2009.
At sentencing, scheduled for July 25, 2013, Mahbub faces a maximum penalty of 10 years in prison.
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Source- http://www.justice.gov/usao/pae/News/2013/Apr/kuranplea_release.htm
PHILADELPHIA - Feda Kuran, 37, of Philadelphia, PA, pleaded guilty today to a health care fraud scheme that involved billing Medicare for ambulance services that were not medically necessary, that were not actually provided, or that were induced by illegal kickbacks. During this health care fraud scheme, the defendant also gave and received illegal kickbacks. As a result, the Medicare program paid more than $2,015,712 for the fraudulent bills. Kuran pleaded guilty to one count of Health Care Fraud and one count of violating the Anti-Kickback Statute. U.S. District Court Judge William H. Yohn, Jr. scheduled a sentencing hearing for July 24, 2013. Kuran faces a maximum possible sentence of 15 years in prison, three years of supervised release, a $250,000 fine, a $200 special assessment, and restitution to Medicare. In addition, the defendant has agreed to forfeiture and a money judgment against her for more than $2 million.
As documents filed in connection with the plea revealed, in July 2010, the defendant began operating Brotherly Love Ambulance, Inc. with a co-schemer. Kuran, or others acting at her direction, transported patients by ambulance when those patients could have been transported safely by other means and were, therefore, not eligible for ambulance service under Medicare and Medicaid requirements. Not only were those patients able to be safely transported by means other than ambulance, but also many of the patients were observed walking to and from ambulances. The defendant and others billed Medicare for ambulance services for patients who were transported by Brotherly Love employees in personal vehicles or who drove themselves or took public transportation to their destinations. In addition, the defendant and other employees paid kickbacks to some patients to induce them to allow Brotherly Love Ambulance, Inc. to transport them. Brotherly Love paid other patients so that the ambulance company could use those patients’ information to bill for transportation that Brotherly Love Ambulance never actually provided. The defendant also agreed that she received kickbacks from other ambulance companies to refer patients to the other ambulance companies.
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