Former Social Security Administrative Law Judge Sentenced to Four Years in Prison for Role in $550 Million Social Security Fraud Scheme

Friday, August 25, 2017

A former social security administrative law judge (ALJ) was sentenced today to four years in prison for his role in a scheme to fraudulently obtain more than $550 million in federal disability payments from the Social Security Administration (SSA) for thousands of claimants.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Special Agent in Charge Michael McGill of the Social Security Administration-Office of Inspector General’s (SSA-OIG) Philadelphia Field Division, Special Agent in Charge Amy S. Hess of the FBI’s Louisville Field Division, Special Agent in Charge Tracey D. Montaño of the IRS Criminal Investigation (IRS-CI) Nashville Field Office and Special Agent in Charge Derrick L. Jackson of the U.S. Department of Health and Human Services-Office of the Inspector General (HHS-OIG) Atlanta Regional Office made the announcement.

David Black Daugherty, 81, of Myrtle Beach, S.C., was sentenced by U.S. District Judge Danny C. Reeves of the Eastern District of Kentucky, who also ordered Daugherty to pay restitution of over $93 million to the SSA and HHS. Daugherty pleaded guilty in May 2017 to two counts of receiving illegal gratuities.

According to admissions made as part of his guilty plea, beginning in 2004, Daugherty, as an ALJ assigned to the SSA’s Huntington, W. Va., hearing office, sought out pending disability cases in which Kentucky attorney Eric Christopher Conn represented claimants and reassigned those cases to himself. Daugherty then contacted Conn and identified the cases he intended to decide the following month and further solicited Conn to provide medical documentation supporting either physical or mental disability determinations. Without exception, Daugherty awarded disability benefits to individuals represented by Conn – in some instances, without first holding a hearing. As a result of Daugherty’s awarding disability benefits to claimants represented by Conn, Conn paid Daugherty an average of approximately $8,000 per month in cash, until approximately April 2011. All told, Daugherty received more than $609,000 in cash from Conn for deciding approximately 3,149 cases.

As a result of the scheme, Conn, Daugherty, and their co-conspirators obligated the SSA to pay more than $550 million in lifetime benefits to claimants based upon cases Daugherty approved for which he received payment from Conn.

Daugherty was indicted last year, along with Conn and Alfred Bradley Adkins, a clinical psychologist. The defendants were charged with conspiracy, fraud, false statements, money laundering and other related offenses in connection with the scheme.

Conn pleaded guilty on March 24, to a two-count information charging him with theft of government money and paying illegal gratuities, and was sentenced in absentia on July 14 to 12 years in prison. Conn absconded from court ordered-electronic monitoring on June 2, and is considered a fugitive. He remains under indictment. On June 12, Adkins was convicted after a jury trial of one count of conspiracy to commit mail fraud and wire fraud, one count of mail fraud, one count of wire fraud and one count of making false statements. Adkins is scheduled to be sentenced on September 22.

The SSA-OIG, FBI, IRS-CI and HHS-OIG investigated the case. Trial Attorney Dustin M. Davis of the Criminal Division’s Fraud Section and Trial Attorney Elizabeth G. Wright of the Criminal Division’s Money Laundering and Asset Recovery Section are prosecuting the case, with previous co-counsel including Assistant U.S. Attorney Trey Alford of the Western District of Missouri and Investigative Counsel Kristen M. Warden of the Justice Department’s Office of the Inspector General.

Houston Home Health Agency Owner Sentenced to 480 Months in Prison for Conspiring to Defraud Medicare and Medicaid of More Than $17 Million

Friday, August 18, 2017

WASHINGTON – The owner and operator of five Houston-area home health agencies was sentenced on Thursday to 480 months in prison for conspiring to defraud Medicare and the State of Texas’ Medicaid-funded Home and Community-Based Service (HCBS) and Primary Home Care (PHC) Programs of more than $17 million and launder the money that he stole from Medicare and Medicaid.  The HCBS and PHC Programs provided qualified individuals with in-home attendant and community-based services that are known commonly as “provider attendant services” (PAS).  This case marks the largest PAS fraud case charged in Texas history.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Abe Martinez of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge C.J. Porter of the Department of Health and Human Services Office of the Inspector General’s (HHS-OIG) Dallas Regional Office, Special Agent in Charge D. Richard Goss of IRS Criminal Investigation’s (CI) Houston Field Office and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.

Godwin Oriakhi, 61, of Houston, was sentenced by U.S. District Judge Sim Lake of the Southern District of Texas.  In March 2017, Oriakhi pleaded guilty to two counts of conspiracy to commit health care fraud and one count of conspiracy to launder monetary instruments.

According to admissions made as part of Oriakhi’s plea, he, his co-defendant daughter and other members of his family owned and operated Aabraham Blessings LLC, Baptist Home Care Providers Inc., Community Wide Home Health Inc., Four Seasons Home Healthcare Inc. and Kis Med Concepts Inc., all of which were home health agencies in the Houston area.  Oriakhi admitted that he, along with his daughter and other co-conspirators, obtained patients for his home health agencies by paying illegal kickback payments to patient recruiters and his office employees for hundreds of patient referrals.  In his plea, Oriakhi also admitted that he, along with his daughter and co-conspirators, paid Medicare and Medicaid patients by cash, check, Western Union and Moneygram for receiving services from his family’s home health agencies in exchange for the ability to use the patients’ Medicare and Medicaid numbers to bill the programs for home healthcare and PAS services.  Oriakhi admitted that he, his daughter and their co-conspirators also directly paid some of these patients for recruiting and referring other Medicare and Medicaid patients to his agencies.  Additionally, Oriakhi admitted that he, his daughter and other co-conspirators paid physicians illegal kickbacks payments, which Oriakhi and his co-conspirators called “copayments,” for referring and certifying Medicare and Medicaid patients for home health and PAS services.

Oriakhi further admitted that each time he submitted a claim predicated on an illegal kickback payment he knew he was submitting a fraudulent claim to Medicare or Medicaid based on his false representations that the claim and the underlying transaction complied with the federal Anti-Kickback Statute and other state and federal laws.  Oriakhi further admitted that he knew that Medicare and Medicaid would not otherwise pay for the fraudulent claims, according to his plea.  In addition to the home health care and PAS services fraud scheme, Oriakhi admitted that he and his co-conspirators used the money fraudulently obtained from Medicare and Medicaid to make illegal kickback payments to patient recruiters, employees, physicians and patients to promote the Medicare home health and Medicaid PAS fraud conspiracies, and ensure their successful continuation.

In total, Oriakhi that he and his co-conspirators submitted approximately $17,819,456 in fraudulent home healthcare and PAS claims to Medicare and Medicaid and received approximately $16,198,600 on those claims.

To date, three others have pleaded guilty based on their roles in the fraudulent scheme at Oriakhi’s home healthcare agencies.  Oriakhi’s daughter, Idia Oriakhi, and Charles Esechie, a registered nurse who was Baptist’s primary admissions nurse, each pleaded guilty to one count of conspiring with Oriakhi and others to commit health care fraud.  Jermaine Doleman, a patient recruiter, pleaded guilty to conspiring with Oriakhi and others to commit health care fraud and launder money.  Doleman was also charged in two other healthcare fraud cases.  Esechie was also sentenced on August 17, to 60 months in prison.  Idia Oriakhi and Jermaine Doleman are awaiting sentencing.

The case was investigated by the IRS-CI, FBI, HHS-OIG and MFCU under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas.  The case is being prosecuted by Senior Trial Attorney Jonathan T. Baum and Trial Attorneys Aleza S. Remis and William S.W. Chang of the Fraud Section of the Justice Department’s Criminal Division.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  The Medicare Fraud Strike Force operates in nine locations nationwide.  Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Owner of Home Health Agency Sentenced to 75 Years in Prison for Involvement in $13 Million Medicare Fraud Conspiracy

Friday, August 11, 2017

The owner and director of nursing of a Houston home health agency was sentenced today to 75 years in prison for her role in a $13 million Medicare fraud scheme.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Abe Martinez of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Dallas Region and Special Agent in Charge D. Richard Goss of the Houston Field Office of IRS-Criminal Investigation Division (IRS-CI) made the announcement.

Marie Neba, 53, of Sugarland, Texas, was sentenced by U.S. District Judge Melinda Harmon of the Southern District of Texas.  In November 2016, Neba was convicted after a two-week jury trial of one count of conspiracy to commit health care fraud, three counts of health care fraud, one count of conspiracy to pay and receive health care kickbacks, one count of payment and receipt of health care kickbacks, one count of conspiracy to launder monetary instruments and one count of making health care false statements.

According to the evidence presented at trial, from February 2006 through June 2015, Neba and others conspired to defraud Medicare by submitting over $10 million in false and fraudulent claims for home health services to Medicare through Fiango Home Healthcare Inc., owned by Neba and her husband, Ebong Tilong, 53, also of Sugarland, Texas.  The trial evidence showed that using the money that Medicare paid for such fraudulent claims, Neba paid illegal kickbacks to patient recruiters for referring Medicare beneficiaries to Fiango for home health services.  Neba also paid illegal kickbacks to Medicare beneficiaries for allowing Fiango to bill Medicare using beneficiaries’ Medicare information for home health services that were not medically necessary or not provided, the evidence showed.  Neba falsified medical records to make it appear as though the Medicare beneficiaries qualified for and received home health services.  Neba also attempted to suborn perjury from a co-defendant in the federal courthouse, the evidence showed.

According to the evidence presented at trial, from February 2006 to June 2015, Neba received more than $13 million from Medicare for home health services that were not medically necessary or not provided to Medicare beneficiaries.

To date, four others have pleaded guilty based on their roles in the fraudulent scheme at Fiango.  Nirmal Mazumdar, M.D., the former medical director of Fiango, pleaded guilty to a scheme to commit health care fraud for his role at Fiango.  Daisy Carter and Connie Ray Island, two patient recruiters for Fiango, pleaded guilty to conspiracy to commit health care fraud for their roles at Fiango.  On August 11, Island was sentenced to 33 months in prison.  Mazumdar and Carter are awaiting sentencing.  After the first week of trial, Tilong pleaded guilty to one count of conspiracy to commit healthcare fraud, three counts of healthcare fraud, one count of conspiracy to pay and receive healthcare kickbacks, three counts of payment and receipt of healthcare kickbacks, and one count of conspiracy to launder monetary instruments.  Tilong is scheduled to be sentenced on October 13.

The case was investigated by the IRS-CI, FBI and HHS-OIG under the supervision of the Fraud Section of the Justice Department’s Criminal Division and the U.S. Attorney’s Office for the Southern District of Texas.  The case is being prosecuted by Trial Attorney William S.W. Chang and Senior Trial Attorney Jonathan T. Baum of the Fraud Section.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  The Medicare Fraud Strike Force operates in nine locations nationwide.  Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Registered Nurse Who Owned Two Houston Home Health Companies Convicted in $20 Million Medicare Fraud Scheme

Thursday, August 10, 2017

A federal jury today convicted a registered nurse who was the owner of two home health companies in Houston for her role in a $20 million Medicare fraud scheme involving fraudulent claims for home health services.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Abe Martinez of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Dallas Region made the announcement.

After a four-day trial, Evelyn Mokwuah, 52, of Pearland, Texas, was convicted of one count of conspiracy to commit health care fraud and four counts of health care fraud for her conduct at Beechwood Home Health (Beechwood) and Criseven Health Management Corporation (Criseven).  Sentencing has been scheduled for October 6, before U.S. District Judge Gray H. Miller of the Southern District of Texas, who presided over the trial.

According to evidence presented at trial, from 2008 to 2016, Mokwuah and others engaged in a scheme to defraud Medicare of approximately $20 million in fraudulent claims for home health services at Beechwood and Criseven that were not provided or not medically necessary.  According to the trial evidence, Mokwuah billed for patients who were not homebound or did not qualify for home health services; Mokwuah and others falsified patient records to show patients were homebound when they were not; Mokwuah paid patient recruiters to recruit Medicare beneficiaries to Beechwood and Criseven; and Mokwuah paid doctors to sign off on falsified plans of care for the recruited beneficiaries so that Beechwood and Criseven could bill Medicare for those services.

Co-defendant Amara Oparanozie, 47, of Richmond, Texas, pleaded guilty on May 24, to conspiring with Mokwuah and others to commit health care fraud and is awaiting sentencing.

The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas.  The case is being prosecuted by Trial Attorneys Scott Armstrong and Kevin Lowell of the Criminal Division’s Fraud Section.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the department and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

Naval Employee Pleads Guilty to Accepting More Than $250,000 in Cash Bribes From Unauthorized Liquor Buyers

Tuesday, August 1, 2017

An employee of the U.S. Department of the Navy pleaded guilty today to accepting more than $250,000 in cash bribes from three people making unauthorized liquor purchases from the Navy Exchange Service Command where he worked, announced Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division and Special Agent in Charge Leo Lamont of the Naval Criminal Investigative Service’s (NCIS) Northeast Field Office.

Eric Jex, 29, of Uniondale, New York, pleaded guilty to one count of bribery before U.S. District Judge Joanna Seybert of the Eastern District of New York. Sentencing is set for Feb. 2, 2018.

According to admissions made in connection with his guilty plea, as a supervisory sales associate at the NEX at Mitchel Field in Garden City, New York, Jex was responsible for preparing and processing retail transactions, and he had direct authority to make decisions concerning large liquor orders and shipments from the NEX’s warehouse. He was also subject to policies limiting access to the NEX’s goods to authorized personnel, such as Navy service members, and requiring NEX employees to check purchasers’ IDs. In connection with his guilty plea, Jex admitted that from approximately November 2015 through December 2016, he agreed with three unauthorized purchasers, one of whom had a New York State Liquor License, to arrange repeated large purchases of liquor from the NEX. He allowed the three unauthorized purchasers access to the NEX’s low prices and frequently provided additional price-matching discounts to which the purchasers were not entitled. In exchange, the three unauthorized purchasers paid cash bribes to Jex, typically $5 to $20 per case of liquor. According to plea documents, these bribes added up to more than $250,000 for the period of the scheme.

The NCIS; U.S. Treasury Department, Alcohol and Tobacco Tax and Trade Bureau; and the New York State Department of Taxation and Finance, Criminal Investigations Division investigated this case. Trial Attorneys Luke Cass and Andrew Laing of the Criminal Division’s Public Integrity Section are prosecuting the case with the assistance of the U.S. Attorney’s Office for the Eastern District of New York.

Former Government Contractor Sentenced to 60 Months for His Participation in Bribery Conspiracy

Friday, July 28, 2017

A former owner of a government contracting company that serviced the Military Sealift Command (MSC) was sentenced to 60 months in prison, and to pay a $15,000 fine, for his participation in a bribery conspiracy from approximately 1999 to 2014, in which he provided a contracting official at MSC with almost $3 million in bribes.  Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division and U.S. Attorney Dana J. Boente of the Eastern District of Virginia made the announcement.

U.S. District Judge Arenda L. Wright Allen today sentenced Joseph P. Allen, 56, of Panama City, Florida, following his guilty plea on April 19, to one count of conspiracy to commit bribery.

According to the statement of facts included in Allen’s guilty plea, Allen conspired with a government contracting official, Scott B. Miserendino, Sr., 58, formerly of Stafford, Virginia, to use Miserendino’s position at MSC to enrich themselves through bribery.  Specifically, beginning in about 1999, Miserendino used his position and influence at MSC to facilitate and expand Allen’s company’s commission agreement with a third-party telecommunications company that sold maritime satellite services to MSC.  Unknown to MSC or the telecommunications company, throughout the scheme, Allen paid half of the commissions he received from that telecommunications company to Miserendino as bribes.

For his role in the scheme, Miserendino was charged in a five-count indictment on May 4, with one count of conspiracy to commit bribery and honest services mail fraud, one count of bribery, and three counts of honest services mail fraud.  His trial is currently scheduled for October 31, before U.S. District Court Judge Rebecca Beach Smith.  The charges and allegations against Miserendino contained in the indictment are merely accusations. The defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

The Norfolk offices of the FBI, the Defense Criminal Investigative Service and the Naval Criminal Investigative Service investigated the case.  Trial Attorneys Sean F. Mulryne and Molly Gaston of the Criminal Division’s Public Integrity Section and Assistant U.S. Attorney Stephen W. Haynie of the Eastern District of Virginia are prosecuting the case.

Chairman of a Macau Real Estate Development Company Convicted on All Counts for Role in Scheme to Bribe United Nations Ambassadors to Build a Multi-Billion Dollar Conference Center

Friday, July 28, 2017

Yesterday, a federal jury convicted the chairman of a real estate development company for his role in a scheme to bribe United Nations ambassadors to obtain support to build a conference center in Macau that would host, among other events, the annual United Nations Global South-South Development Expo.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Joon H. Kim of the Southern District of New York, Assistant Director in Charge William F. Sweeney, Jr. of the FBI’s New York Field Office and Chief Don Fort of Internal Revenue Service Criminal Investigation (IRS-CI) made the announcement.

After a four week trial, Ng Lap Seng, a/k/a “David Ng,” 69, of Macau, China, was convicted of two counts of violating the Foreign Corrupt Practices Act, one count of paying bribes and gratuities, one count of money laundering and two counts of conspiracy. No sentencing date has been set.

“The defendant’s corrupt activities were all the more egregious and shameful as he tried to hide his bribes as philanthropy,” said Acting Assistant Attorney General Blanco. “Corruption is a disease that has a corrosive effect on the rule of law everywhere and harms good people throughout the world. The Department is steadfast in its mission to aggressively investigate and prosecute bribery in all its forms, and vigorously protect the rule of law.”

“In his unbridled pursuit of even greater personal fortune, billionaire Ng Lap Seng corrupted the highest levels of the United Nations,” said Acting U.S. Attorney Kim. “Through bribes and no show jobs, Ng turned leaders of the league of nations into his private band of profiteers. Ng’s journey from a Macau real estate mogul to convicted felon should serve as a cautionary tale to all tempted to follow his path. If you bring corruption to New York – whether to the State Capitol in Albany or to the halls of the U.N. General Assembly – your journey may very well end in a Manhattan federal courtroom, with a unanimous jury announcing your guilt.”

“Ng’s bribery scheme began at the intersection where business and intergovernmental matters overlap,” said Assistant Director in Charge Sweeney, Jr. He may have thought this was a good place to start, but it’s doubtful this was the ending he had in mind. This case is nothing more than an example of corruption in its purest form, and we’ve proven once again that no individual or organization is powerful enough to be immune from prosecution.”

“Today’s conviction is a result of untangling a global labyrinth of complex financial transactions used by Seng to facilitate bribes to foreign officials,” said Chief Fort. “IRS-CI has become a trusted leader in pursuit of those who use corruption as their business model to circumvent the law. CI is committed to maintaining fair competition, free of corrupt practices, through a dynamic synthesis of global teamwork and our robust financial investigative talents.”

According to the evidence presented at trial, Ng, the chairman of the Sun Kian Ip Group, conspired with and paid bribes to Francis Lorenzo, a former UN Ambassador from the Dominican Republic, and John W. Ashe, the late former Permanent Representative of Antigua and Barbuda to the UN and the 68th President of the UN General Assembly (“UNGA”). With the assistance of Jeff C. Yin, an accountant and co-conspirator who worked with Ng and others and previously pleaded guilty, Ng orchestrated a scheme with the principal objective of obtaining the formal support of the UN for a multi-billion dollar facility that Ng hoped to build in Macau using the Sun Kian Ip Group (the “Macau Conference Center”). Ng wanted the Macau Conference Center to serve as a location for meetings, discussions, forums, and other events associated with the UN. In particular, he wanted it to serve as the permanent home of the annual “Global South-South Development Expo,” which is run by the UN Office for South-South Cooperation, and is hosted in a different country or city every year.

The trial evidence further showed that Ng bribed Ambassador Ashe and Ambassador Lorenzo (together, the “Ambassadors”) in exchange for their agreement to use their official positions to advance Ng’s interest in obtaining formal UN support for the Macau Conference Center. As the evidence demonstrated at trial, Ng paid the Ambassadors in a variety of forms. For example, Ng appointed Ambassador Lorenzo as the President of South-South News, a New York-based organization — funded by Ng — which described itself as a media platform dedicated to advancing the implementation of the UN’s Millennium Development Goals, a set of philanthropic goals. Ng provided bribe payments to Ambassador Lorenzo through South-South News by transmitting payments from Macau to a company in the Dominican Republic affiliated with Ambassador Lorenzo’s brother (the “Dominican Company”). Through South-South News, Ng also made payments to Ambassador Ashe, including to Ambassador Ashe’s wife, who was paid in her capacity as a “consultant” to South-South News, and to an account that Ambassador Ashe had established, purportedly to raise money for his role as President of UNGA. Ng also provided bribes through cash and wire payments to the Ambassadors.

According to the trial evidence, one of the actions that the Ambassadors took in exchange for bribe payments, to advance Ng’s objectives, was to submit an official document to the then-UN Secretary-General in support of the Macau Conference Center (the “UN Document”). The UN Document claimed that there was a need to build the Macau Conference Center to support the UN’s global development goals. Ambassador Ashe, aided by Ambassador Lorenzo, initially submitted the UN Document to the UNGA in or about late February 2012. More than a year later, at Ng’s behest, the Ambassadors revised the UN Document to refer specifically to Ng’s company, the Sun Kian Ip Group, as a partner in the Macau Conference Center project. The UN Document requested that the Secretary-General circulate the UN Document “as a document of the sixty-sixth session of the General Assembly,” under a specific item of the official UNGA agenda. The Secretary-General followed this request, thereby making the UN Document an official part of the UNGA record.

Five other defendants have been charged in this matter. Co-conspirators Lorenzo, Yin and Heidi Hong Piao have pleaded guilty and are awaiting sentencing. Shiwei Yan has pleaded and was sentenced to 20 months in prison. Co-defendant Ashe passed away in 2016 and the charges against him were dismissed.

This case was investigated by the FBI and IRS-CI. Trial Attorney David A. Last of the Criminal Division’s Fraud Section and Assistant U.S. Attorneys Daniel C. Richenthal, Janis M. Echenberg and Douglas S. Zolkind of the Southern District of New York are prosecuting the case.

The Criminal Division’s Fraud Section is responsible for investigating and prosecuting all FCPA matters. Additional information about the Justice Department’s FCPA enforcement efforts can be found at www.justice.gov/criminal/fraud/fcpa.

Pharmacist Pleads Guilty to Health Care Fraud Charges for Role in $192 Million Compounded Medication Scheme; Pharmacy Marketer Also Pleads Guilty

Tuesday, July 25, 2017

The Pharmacist in Charge of a Hattiesburg, Mississippi compounding pharmacy pleaded guilty today to health care fraud charges for his role in a scheme that defrauded TRICARE and private insurance companies out of at least $192 million in payments for medically unnecessary compounded medications.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Harold Brittain of the Southern District of Mississippi, Special Agent in Charge Christopher Freeze of the FBI’s Jackson Division, Special Agent in Charge Jerome R. McDuffie of the Internal Revenue Service – Criminal Investigation’s New Orleans Field Office and John F. Khin and the Defense Criminal Investigative Service Southeast Field Office made the announcement.

May, 40, of Lamar County, Mississippi, pleaded guilty to one count of conspiracy to commit health care fraud and money laundering before U.S. District Judge Keith Starrett of the Southern District of Mississippi. Sentencing has been scheduled for October 17 before Judge Starrett.

As part of his guilty plea, May admitted that he conspired with others to select compounded medication formulas based on profitability, rather than on effectiveness or patient need. He further admitted that he conspired with co-owners of the pharmacy to circumvent fraud prevention measures, such as collecting copayments, so that patients were incentivized to receive, and continue to receive, medically unnecessary medications.  According to plea documents, May dispensed these medically unnecessary compounded medications and caused fraudulent claims to be submitted to TRICARE, a health care program that benefits members of the U.S. armed forces, and other health care benefit programs. Based on these fraudulent claims, May and his co-conspirators received at least $192 million in reimbursements.

In a related case, Gerald Schaar, 46, of Biloxi, Mississippi, pleaded guilty to one count of conspiracy to commit health care fraud for his role in the scheme to defraud TRICARE. According to plea documents, Schaar admitted to soliciting physicians and other medical professionals to write prescriptions without seeing patients for medically unnecessary compounded medications dispensed by the pharmacy. According to the plea documents, Schaar further admitted to conspiring with others to falsify patient records to make it appear as though medical professionals had seen patients prior to the date prescriptions were written, when in reality, no examinations had occurred. As a result of the fraudulent prescriptions obtained by Schaar, and ultimately forwarded to the pharmacy, TRICARE reimbursed approximately $2.3 million in false and fraudulent claims submitted by the pharmacy. Sentencing for Schaar has been scheduled for October 17 before Judge Starrett.

This case was investigated by the FBI Jackson Division’s Hattiesburg Resident Agency, the IRS Criminal Investigation, the Defense Criminal Investigative Service, Health and Human Services Office of Inspector General, the Mississippi Bureau of Narcotics, and other government agencies. Trial Attorneys Dustin Davis and Katherine Payerle of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Mary Helen Wall of the Southern District of Mississippi are prosecuting the case.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide.  Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Individuals who believe that they may be a victim in this case should visit the Fraud Section’s Victim Witness website for more information.

Houston Physician Convicted of Conspiracy in $1.5 Million Medicare Fraud Scheme

Friday, July 21, 2017

A federal jury convicted a Houston physician today for his role in a scheme involving approximately $1.5 million in fraudulent Medicare claims for home health care services and various medical testing and services.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Abe Martinez of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Dallas Region and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.

After a four-day trial, Ronald F. Kahn, M.D., 62, of Harris County, Texas, was convicted of one count of conspiracy to commit health care fraud and one count of conspiracy to pay and receive illegal kickbacks. Sentencing has been scheduled for September 25, before U.S. District Judge Kenneth M. Hoyt, who presided over the trial.

According to evidence presented at trial, from approximately 2006 until 2013, Kahn and others engaged in a scheme to defraud Medicare out of approximately $1.5 million in fraudulent claims for home heath care services in connection with Allied Covenant Home Health, Inc., a Houston home healthcare agency (Allied).  Kahn fraudulently admitted patients for home health care with Allied when they did not qualify for such services, the evidence showed. To make it appear that these patients did qualify, Kahn falsified medical records and signed false documents purporting to show that patients admitted to Allied’s home health program satisfied Medicare’s requirements for admission, the evidence showed.

The evidence also showed that Kahn paid illegal kickbacks for patients from Harris Health Care Group, a Houston medical clinic (Harris). Kahn paid illegal kickbacks to the owner of Harris in order to bill Medicare for facet injections that were medically unnecessary, not provided or both, the evidence showed.

The case was investigated by the FBI, HHS-OIG and Texas MFCU, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas. The case is being prosecuted by Assistant Chief Ashlee McFarlane and Trial Attorney Scott Armstrong of the Fraud Section.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  The Medicare Fraud Strike Force operates in nine locations nationwide.  Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

Telecom Executive Pleads Guilty to FCPA Charge in Connection With Haitian Bribery Scheme

Wednesday, July 19, 2017

The former general manager of a Miami-based telecommunications company pleaded guilty today for his role in a scheme to pay $3 million in bribes to various Haitian officials to secure a lucrative contract with Telecommunications D’Haiti (Haiti Teleco), the state-owned and state-controlled telecommunications company in Haiti.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Benjamin G. Greenberg of the Southern District of Florida, Special Agent in Charge Kelly R. Jackson of Internal Revenue Service-Criminal Investigation’s (IRS-CI) Miami Field Office made the announcement.

Amadeus Richers, 66, of Brazil, pleaded guilty in federal court in Miami to count one of a second superseding indictment charging him with conspiracy to violate the Foreign Corrupt Practices Act (FCPA).  According to admissions in the plea documents, beginning in 2001 and lasting until 2004, Richers and his co-conspirators paid roughly $3 million in bribes directly and indirectly to foreign officials employed by Haiti Teleco and to a foreign official in the executive branch of the Haitian government in order to secure a favorable contract and favorable treatment in connection with that contract from Haiti Teleco.  The co-conspirators funneled some of the money through third-party intermediaries and paid other money directly to officials or relatives of officials, Richers admitted.

Richers is the ninth defendant to have pled guilty or to have been convicted at trial in this case.  On April 27, 2009, Antonio Perez, a former controller at one of the Miami-based telecommunications companies, pleaded guilty to one count of conspiracy to violate the FCPA and money laundering.  On May 15, 2009, Juan Diaz, the president of J.D. Locator Services, pleaded guilty to one count of conspiracy to violate the FCPA and money laundering.  On Feb. 19, 2010, Jean Fourcand, the president and director of Fourcand Enterprises Inc., pleaded guilty to one count of money laundering for receiving and transmitting bribe monies in the scheme.  On March 12, 2010, Robert Antoine, a former director of international affairs for Haiti Teleco, pleaded guilty to one count of conspiracy to commit money laundering.  On Aug. 4, 2011, Joel Esquenazi and Carlos Rodriguez, who were the former president and vice-president, respectively, of one of the telecommunications companies, were convicted by a federal jury of one count of conspiracy to violate the FCPA and wire fraud, seven counts of FCPA violations, one count of money laundering conspiracy and 12 counts of money laundering.  On Feb. 8, 2012, Patrick Joseph, a former executive director of Haiti Teleco, pleaded guilty to one count of conspiracy to commit money laundering.  On March 12, 2012, Jean Rene Duperval, a former director of international relations for Haiti Teleco, was convicted by a federal jury of two counts of conspiracy to commit money laundering and 19 counts of money laundering.

Richers was indicted on July 12, 2011, but remained a fugitive until his arrest and ultimately his extradition from Panama on February 23. Richers will be sentenced on September 20.

The Department of Justice is grateful to the government of Haiti for continuing to provide substantial assistance in gathering evidence during this investigation.  In particular, Haiti’s financial intelligence unit, the Unité Centrale de Renseignements Financiers (UCREF), the Bureau des Affaires Financières et Economiques (BAFE), which is a specialized component of the Haitian National Police, and the Ministry of Justice and Public Security provided significant cooperation and coordination in this ongoing investigation.

The Department of Justice also thanks Panama for its significant assistance in this matter.

IRS-CI is conducting the investigation.  Senior Litigation Counsel Nicola Mrazek and Trial Attorney Vanessa Snyder of the Criminal Division’s Fraud Section are prosecuting the case.  The Criminal Division’s Office of International Affairs provided assistance.

The Fraud Section is responsible for investigating and prosecuting all FCPA matters.  Additional information about the Justice Department’s FCPA enforcement efforts can be found at www.justice.gov/criminal-fraud/foreign-corrupt-practices-act.