Dallas Doctor Sentenced on Health Care Fraud Conviction

Wednesday, August 9, 2017

DALLAS — A 60-year-old doctor from Rockwall, Texas, Jacques Roy, who was convicted in April 2016 of various health care fraud charges following a six-week-long trial, was sentenced today by U.S. District Judge Sam A. Lindsay to 420 months in federal prison and ordered to pay $268,147,699.15 in restitution, joint and several with all codefendants to Medicare and Medicaid, announced U.S. Attorney John Parker of the Northern District of Texas.

Roy was convicted of one count of conspiracy to commit health care fraud, eight counts of health care fraud, two counts of making a false statement relating to healthcare matters and one count of obstruction of justice. Roy has been in custody since the time of his arrest in February 2012.

“The only thing more stunning than Jacques Roy and his co-conspirators’ shameless methods, said U.S. Attorney Parker, is the staggering dollar amounts involved in this fraud scheme. This takes brazen to a whole new level.”

The following defendants have also been sentence for their role in the health care fraud scheme:

  • Wilbert James Vesey, Jr., 210 months in federal prison and $23 million in restitution
  • Cyprian Akamnonu, 120 months in federal prison and $25 million in restitution
  • Patricia Akamnonu, 120 months in federal prison and $25 million in restitution
  • Charity Eleda, 48 months in federal prison and $397,294.51 in restitution
  • Teri Sivils, 3 years probation and $885,714.05 in restitution

Cynthia Stiger will be sentenced October 26, 2017.

The government presented evidence at trial that Dr. Roy, Stiger, Veasey and Eleda engaged in a large-scale, sophisticated health care fraud scheme in which they conspired together and with others to defraud Medicare and Medicaid through companies they owned/controlled: Medistat Group Associates, P.A., Apple of Your Eye Health Care Services, Inc., Ultimate Care Home Health Services and Charry Home Care Services.

As part of the conspiracy, Stiger, Veasey and Eleda, along with others, improperly recruited individuals with Medicare coverage to sign up for Medicare home health care services. Eleda recruited patients from The Bridge homeless shelter in Dallas, sometimes paying recruiters $50 per beneficiary they found and directed to her vehicle parked outside the shelter’s gates. Eleda and other nurses would falsify medical documents to make it appear as though those beneficiaries qualified for home health care services that were not medically necessary. Eleda and the nurses prepared Plans of Care (POC), also known as 485’s, which were not medically necessary, and these POCs were delivered to Dr. Roy’s office and not properly reviewed by any physician.

Dr. Roy instructed his staff to certify these POCs, which indicated to Medicare and Medicaid that a doctor, typically Dr. Roy, had reviewed the treatment plan and deemed it medically necessary. That certifying doctor, typically Dr. Roy, certified that the patient required home health services, which were only permitted to be provided to those individuals who were homebound and required, among other things, skilled nursing. This process was repeated for thousands of POCs, and, in fact, Medistat’s office included a “485 Department,” essentially a “boiler room” to affix fraudulent signatures and certifications.

Once an individual was certified for home health care services, Eleda, nurses who worked for Stiger and Veasey, and other nurses falsified visit notes to make it appear as though skilled nursing services were being provided and continued to be necessary. Dr. Roy would also visit the patients, perform unnecessary home visits, and then order unnecessary medical services for the recruited beneficiaries. Then, at Dr. Roy’s instruction, Medistat employees would submit fraudulent claims to Medicare for the certification and recertification of unnecessary home health care services and other unnecessary medical services.

The government presented further evidence at trial that the scope of Dr. Roy’s fraud was massive; Medistat processed and approved POCs for 11,000 unique Medicare beneficiaries from more than 500 different home health agencies. Dr. Roy entered into formal and informal fraudulent arrangements with Apple, Charry, Ultimate and other home health agencies to ensure his fraudulent business model worked and that he maintained a steady stream of Medicare beneficiaries.

Regarding Dr. Roy’s conviction for obstruction of justice, the government presented evidence that when the Centers for Medicare and Medicaid Services (CMS) suspended Dr. Roy and Medistat from receiving Medicare payments after June 2, 2011, because of suspected fraud, Dr. Roy sought an “end-run” around the suspension through the use of another company, Medcare House Calls. Dr. Roy directed the medical providers he employed to be re-credentialed and to bill Medicare under Medcare House Calls, instead of Medistat. Nonetheless, the money that Medicare paid was circumvented back to Medistat and Dr. Roy.

The case was investigated by the Federal Bureau of Investigation, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) and was brought as part of the Medicare Fraud Strike Force supervised by the Criminal Division Fraud Section and the U.S. Attorney’s Office for the Northern District of Texas.

Assistant U.S. Attorneys P.J. Meitl and Nicole Dana and First Assistant U.S. Attorney Chad Meacham prosecuted the case.

Rowlett Woman Sentenced to 48 Months in Federal Prison for Role in Healthcare Fraud Conspiracy

Wednesday, July 26, 2017

DALLAS — Charity Eleda, R.N., 56, of Rowlett, Texas, was sentenced this morning in federal court in Dallas on a health care fraud conspiracy conviction, announced U.S. Attorney John Parker of the Northern District of Texas.

Eleda was sentenced by U.S. District Judge Sam A. Lindsay to 48 months in federal prison and ordered to pay $397,294.51 in restitution to Medicare. She has been in custody since April 2016, after a federal jury found her guilty of various health care fraud offenses.

Eleda, along with co-defendants, Jacques Roy, M.D., 59, of Rockwall, Texas; Cynthia Stiger, 54, of Dallas; and Wilbert James Veasey, Jr., 65, of Dallas, were each convicted following a six-week-long trial on one count of conspiracy to commit health care fraud. In addition, Roy was convicted on eight, Veasey on three and Eleda on four counts of health care fraud. Roy was also convicted on two counts of making a false statement relating to healthcare matters and one count of obstruction of justice. Eleda was also convicted on three counts of making false statements for use in determining rights of benefit and payment by Medicare.

Three other defendants charged in the case, Cyprian Akamnonu and his registered nurse wife, Patricia Akamnonu, both of Cedar Hill, Texas, and Teri Sivils, of Midlothian, Texas, each pleaded guilty before trial to one count of conspiracy to commit health care fraud. Cyprian and Patricia Akamnonu are each currently serving a ten-year federal prison sentence. They were also ordered to pay $25 million in restitution. Sivils pleaded guilty in April 2015, and was sentenced to 3 years probation.

The government presented evidence at trial that Dr. Roy, Stiger, Veasey and Eleda engaged in a large-scale, sophisticated health care fraud scheme in which they conspired together and with others to defraud Medicare and Medicaid through companies they owned/controlled: Medistat Group Associates, P.A., Apple of Your Eye Health Care Services, Inc., Ultimate Care Home Health Services and Charry Home Care Services.

As part of the conspiracy, Stiger, Veasey and Eleda, along with others, improperly recruited individuals with Medicare coverage to sign up for Medicare home health care services. Eleda recruited patients from The Bridge homeless shelter in Dallas, sometimes paying recruiters $50 per beneficiary they found and directed to her vehicle parked outside the shelter’s gates. Eleda and other nurses would falsify medical documents to make it appear as though those beneficiaries qualified for home health care services that were not medically necessary. Eleda and the nurses prepared Plans of Care (POC), also known as 485’s, which were not medically necessary, and these POCs were delivered to Dr. Roy’s office and not properly reviewed by any physician.

Dr. Roy instructed his staff to certify these POCs, which indicated to Medicare and Medicaid that a doctor, typically Dr. Roy, had reviewed the treatment plan and deemed it medically necessary. That certifying doctor, typically Dr. Roy, certified that the patient required home health services, which were only permitted to be provided to those individuals who were homebound and required, among other things, skilled nursing. This process was repeated for thousands of POCs, and, in fact, Medistat’s office included a “485 Department,” essentially a “boiler room” to affix fraudulent signatures and certifications.

Once an individual was certified for home health care services, Eleda, nurses who worked for Stiger and Veasey, and other nurses falsified visit notes to make it appear as though skilled nursing services were being provided and continued to be necessary. Dr. Roy would also visit the patients, perform unnecessary home visits, and then order unnecessary medical services for the recruited beneficiaries. Then, at Dr. Roy’s instruction, Medistat employees would submit fraudulent claims to Medicare for the certification and recertification of unnecessary home health care services and other unnecessary medical services.

The government presented further evidence at trial that the scope of Dr. Roy’s fraud was massive; Medistat processed and approved POCs for 11,000 unique Medicare beneficiaries from more than 500 different home health agencies. Dr. Roy entered into formal and informal fraudulent arrangements with Apple, Charry, Ultimate and other home health agencies to ensure his fraudulent business model worked and that he maintained a steady stream of Medicare beneficiaries.

The case was investigated by the Federal Bureau of Investigation, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) and was brought as part of the Medicare Fraud Strike Force supervised by the Criminal Division Fraud Section and the U.S. Attorney’s Office for the Northern District of Texas.

Assistant U.S. Attorneys P.J. Meitl and Nicole Dana and First Assistant U.S. Attorney Chad Meacham prosecuted the case.

Canadian Man Sentenced to 97 months in Prison for Investment Scheme

 

Tuesday, June 13, 2017

FORT WORTH — Ryan Steve Magee, a citizen of Canada, was sentenced this morning by Senior U.S. District Judge Terry R. Means to 97 months in federal prison and ordered to pay $2,372,573 in restitution, following his guilty plea in February 2017 to one count of wire fraud, announced U.S. Attorney John Parker of the Northern District of Texas.

Magee, 34, was indicted in July 2016 on five counts of wire fraud. Magee was arrested in December 2016, and has remained in custody since his arrest.

According to plea documents filed in his case, Magee was a business man and an active day trader in the U.S. stock market. Beginning in 2011, and continuing until the end of 2013, Magee devised and operated a scheme to obtain money by means of false and fraudulent material pretense and representations. Magee solicited and obtained money from victim investors by making false representations about how their money would be invested, how much of their money would be invested, how much their investment was earning, how much money they had in their account, and by making other false statements.

Specifically, J.C. and D.C. decided to invest some of their savings with him. At Magee’s direction, D.C. wired $35,000 to Magee’s account on August 12, 2011. After Magee received the money from D.C., he immediately diverted $25,000 for his own personal expenditures. Magee then deposited the remaining $10,000 into his day-trading account located at Interactive Brokers (IB). Magee sent weekly emails to J.C. and D.C. entitled “Trading Update,” which falsely showed the beginning account principal of $35,000 and the daily gains, even though Magee had diverted $25,000 of the investors’ money to his own personal use.

In November 2011, J.C. and D.C. cashed in J.C.’s 401(k) and wired $240,000 to Magee’s account. After Magee received the $240,000, he immediately diverted approximately $160,000 to his personal accounts, transferring only $80,000 into his IB trading account. Magee again sent weekly “Trading Update” emails claiming to have deposited the entire $240,000 in the IB account. Though he lost approximately $75,000 by the end of the month and his trades for November 2011, were a negative 70 percent, Magee listed 200 percent gains in the weekly “Trading Update” emails he sent to J.C. and D.C, between November 16 2011, and November 30, 2011.

On April 10, 2013, in the final “Trading Updates” email Magee sent to J.C. and D.C., Magee claimed their account balance was over $1.3 million. However, Magee’s IB account statement for the time period ending March 31, 2013, showed that Magee’s IB account had a negative cash balance of $9,578. J.C. and D.C. suffered a total loss of approximately $275,000. Between May 2010 and September 2013, other victims of the fraudulent scheme in the United States and Canada suffered a total loss of approximately $2,097,573.

The Federal Bureau of Investigation investigated the case. Assistant U.S. Attorney Nancy Larson prosecuted.

Houston Man Faces Twenty Years in Prison for His Role in $6.5 Million Diamond Fraud Scheme

Tuesday, May 30, 2017

DALLAS — A Houston man, Christopher Arnold Jiongo, appeared this morning before U.S. Magistrate Judge Paul D Stickney and pleaded guilty to one count of wire fraud, announced U.S. Attorney John Parker of the Northern District of Texas.

Jiongo, 55, faces a maximum statutory penalty of twenty years in federal prison and a $250,000 fine. He will remain on bond pending sentencing, which is set for September 11, 2017, before U.S. District Judge David C. Godbey. Co-defendants Craig Allen Otteson, 64, of McKinney and Jay Bruce Heimburger, 58, of Dallas, are scheduled for trial July 17, 2017.

According to plea documents filed in the case, Otteson acted as the Managing Member and Chief Compliance Officer of Stonebridge Advisors, LLC, located on Belt Line road in Dallas. Stonebridge Advisors was involved as the Managing Partner of Worldwide Diamond Ventures, L.P., located at 6029 Belt Line in Dallas, and it acted as the General Partner of Worldwide Diamond. Heimburger acted as a Principal Partner of Worldwide Diamond, and he was also listed as the registered agent and Director of JBH Securities, Inc. located on San Rafael in Dallas. JBH Securities was primarily involved in the business of providing investment advice. Worldwide Diamond was primarily involved in the business of buying and reselling diamonds on the international market. On October 1, 2013, Worldwide Diamond filed for bankruptcy in the Northern District of Texas.

During the summer of 2011 through November 2011, Jiongo drafted $50,000 diamond notes which were later used as investment vehicles to generate investment funds. Jiongo, Otteson and Heimburger represented that all investment funds would be used to buy and resell diamonds and that every dollar invested would always be fully secured by the cash and diamond inventory of Worldwide Diamond. Sometime in the summer of 2011, Jiongo, Otteson and Heimburger realized that the original business plan was not working out as planned and that the defendants therefore could not honor the original promises and representations made to investors. Jiongo, Otteson, and Heimburger then engaged in a scheme to defraud investors by fraudulently concealing from investors that investor funds were being used for unauthorized purposes unrelated to the purchase and resale of diamonds. These unauthorized purposes included making several loans totaling approximately $2.4 million to third parties and to Global Reach Industries Limited for purposes not disclosed to or authorized by the investors. Jiongo, Otteson and Heimburger also fraudulently concealed from Worldwide Diamond investors that defendants planned to make an unauthorized $1 million loan of investor funds to Global Reach Industries Limited, a company established and controlled by defendant Jiongo.

During July 2011, Jiongo, Otteson and Heimburger all agreed to fraudulently wire transfer $400,000 of investor funds into several bank accounts designated by Jiongo. In August 2011, all three defendants agreed that defendant Jiongo would cause another $600,000 of investor funds to be wire transferred directly into a trust account controlled by Jiongo.

As a result of this scheme to defraud during the period from about 2011 through 2012, documents reflect that millions of dollars were fraudulently collected from Worldwide Diamond investors.

This case is one of several felony prosecutions of bankruptcy-related crimes generated by the Bankruptcy Fraud Initiative in the Northern District of Texas. Of the 26 defendants charged as part of that initiative – 17 have been convicted, 1 resulted in a mistrial and 8 are pending trial.

The U.S. Postal Inspection Service investigated the case. Assistant U.S. Attorney David Jarvis is in charge of the prosecution.