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Apple Valley Woman Charged With Defrauding Home Health Care Company, Medica

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FOR IMMEDIATE RELEASE January 10, 2013

MINNEAPOLIS—Yesterday in federal court, an Apple Valley woman was charged with defrauding both her employer and Medica. On January 9, 2012, Lori Jo Mueller, age 48, was charged via an Information with one count of wire fraud and one count of health care fraud.
Allegedly, from June of 2006 through June of 2012, Mueller embezzled approximately $840,000 from Edelweiss Home Health Care and used the funds for her personal use. Mueller began working for Edelweiss, located in Osseo, in 2002, and was promoted to the position of vice president of operations. In that capacity, Mueller was responsible for the review and payment of corporate invoices, bookkeeping, and other financial matters. Mueller allegedly used her access to the corporate checking account to issue payments from corporate accounts to herself. Also, Mueller allegedly concealed her actions from the company owners and made misrepresentations concerning the company’s financial state.
In addition, from March of 2010 through June of 2012, Mueller allegedly defrauded Medica, a health care benefit program. She purportedly submitted claims to various insurers, seeking reimbursement for services provided by Edelweiss nursing staff. In some instances, Mueller double-billed by submitting claims for the same services to multiple insurance providers. For example, Mueller allegedly billed both Minnesota Medicaid and Medica for services provided to one client. The double-billing resulted in a double-payment to Edelweiss with Medicaid being the proper payer and Medica being the overpayer. As a result of this criminal behavior, Mueller obtained for Edelweiss more than $631,000 in fraudulent proceeds. Medica is a non-profit corporation that provides health insurance products to families and individuals.
If convicted in this case, Mueller faces a potential maximum penalty of 30 years in federal prison on the wire fraud count and ten years on the health care fraud count. All sentences will be determined by a federal district court judge.
This case is the result of an investigation by the Federal Bureau of Investigation and the United States Department of Health and Human Services-Office of Inspector General (“DHHS-OIG”). It is being prosecuted by Assistant U.S. Attorney David M. Genrich.
The U.S. Attorney’s Office participates in a task force with the Medicaid Fraud Control Unit at the Minnesota Attorney General’s Office that focuses on home health care fraud trends. The task force includes the DHHS-OIG, the FBI, the Internal Revenue Service, and other federal, state, and local law enforcement partners.
As a result of federal convictions for health care fraud, defendants are excluded from participating in federal health benefit programs, including Medicare and Medicaid. Exclusion determinations are made by the U.S. Department of Health and Human Services. Nationwide, more than 3,000 individuals were excluded from program participation in Fiscal Year 2010 based upon criminal convictions or patient abuse or neglect, license revocations, or other factors.

GeyerGorey LLP Opens Boston Office; Consolidates Mail and Shipping Processing System

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GeyerGorey LLP Opens Boston Office; Consolidates Mail and Shipping Processing System

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DME Owner Convicted of Health Care Fraud and Aggravated Identity Theft

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11/14/2012

HOUSTON – Abdul Waheed Alex Shittu, 54, a naturalized United States citizen from the Federal Republic of Nigeria, has pleaded guilty today to one count of conspiracy to commit health care fraud and one count of aggravated identity theft, United States Attorney Kenneth Magidson announced today.

Shittu, the owner of S & S Medical Supply Etc. located in Stafford, admitted at his re-arraignment today that he began purchasing physician orders for durable medical equipment (DME), including wrist, back, foot, ankle, knee, elbow and shoulder braces as well as wheelchairs around Dec. 1, 2008. Shittu further acknowledged he had at least five recruiters working for him whom he paid $200 – $300 for physician orders which often contained forged physician signatures. The orders were for Medicare and Medicaid beneficiaries who had not been seen or treated by the identified physicians.

Shittu further admitted he billed Medicare and Medicaid for delivery of all the DME on the purchased orders, even though he did not deliver all the DME and he delivered DME to Medicare and Medicaid beneficiaries he knew did not want or need the supplies. Shittu also gave his billing agent the incorrect coding information so he would receive more money from Medicare and Medicaid for each DME claim. Between Dec. 1, 2008, and Sept. 30, 2009, Shittu submitted approximately $1,154,025 in fraudulent claims to Medicare and Medicaid and received $597,865.19 for those claims.

Shittu faces up to 10 years in prison and a $250,000 fine as well as an additional two-year-term of imprisonment for aggravated identity theft which must be served consecutively to any other term imposed. He has been permitted to remain on bond pending his sentencing, set for Jan. 20, 2013.

The investigation into Shittu was the result of a joint investigation conducted by agents from the Department of Health and Human Services-Office of Inspector General and the Texas Attorney General’s Office-Medicaid Fraud Control Unit. Assistant United States Attorney Julie Redlinger prosecuted the case.

California Man Sentenced to 15 Months in Prison For Conspiracy to Defraud USAID of $386,279 – Admitted Scheme to Embezzle Agency Funds Meant for Global Health

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PRESS RELEASE
FOR IMMEDIATE RELEASE For Information Contact:
Tuesday, November 6, 2012 Public Affairs
(202) 252-6933

WASHINGTON – Everett Lipscomb Jr., 42, of Aliso Viejo, Calif., has been sentenced
to 15 months in prison on a charge stemming from his role in a conspiracy to embezzle more than $386,000 from a federal program meant to address global health problems.
The sentence was announced by Ronald C. Machen Jr., U.S. Attorney for the District of
Columbia, and Michael G. Carroll, Deputy Inspector General for the U.S. Agency for
International Development (USAID).
Lipscomb pled guilty in March 2012 to one count of conspiracy to commit wire and mail
fraud, a federal felony. He was sentenced on Nov. 5, 2012 by the Honorable Beryl A. Howell in the U.S. District Court for the District of Columbia. As part of his sentence, Lipscomb was ordered to pay full restitution of $386,279 to USAID. Lipscomb also consented to an order forfeiting any property he owned up to that amount. As indicated in court filings, the government has already seized about $49,000 in proceeds from the scheme from other coconspirators. Upon completion of his prison term, Lipscomb will be placed on two years of supervised release.
As part of his plea, Lipscomb admitted that he conspired together with Mark Adams, a
former deputy director at a private contractor that did business with USAID, and Adams’s wife, Latasha Bell. Lipscomb admitted that Adams used his position at the contracting company to submit and approve false and fraudulent invoices and thereby obtain money.
In Lipscomb’s case, the bogus invoices claimed amounts due for services from Octopus
Limited Audio and Visual, a company controlled by Lipscomb. However, neither Lipscomb nor Octopus – or anyone else – performed the work and services claimed on the invoices. Lipscomb admitted that between April 2008 and August 2010, he received payments from the USAID contracting company totaling $386,279. Of that amount, Lipscomb kept $157,372 for himself and passed the remainder, $228,907, back to Adams and Bell.
Lipscomb further admitted that the fraudulent bills were paid with money that should
have been used for USAID’s global health program. The program addresses major global issues, including HIV/AIDS. At sentencing, Judge Howell noted that the company that employed Adams was seriously impacted by the crime. The company lost its contract with USAID and several employees lost their jobs as a result.
Adams, 44, and Bell, 36, of Fort Washington, Md., pled guilty last month to their roles in
the conspiracy. Adams admitted that the scheme involved more than $1.084 million in
fraudulent payments through such fake invoices between 2006 and 2010. Adams and Bell used the payments to complete an extensive renovation of their home and to buy luxury automobiles.
Adams and Bell are scheduled to be sentenced on Dec. 14, 2012, also before Judge
Howell. Under federal sentencing guidelines, Adams faces a sentence of up to 51 to 63 months of incarceration. Under the plea agreement, Bell agreed to a sentence of home confinement.
In announcing the sentence, U.S. Attorney Machen and Deputy Inspector General Carroll
commended the work of the special agents from the USAID Office of Inspector General, which investigated the case. They also thanked those who worked on the case from the U.S. Attorney’s Office, including Paralegal Specialists Krishawn Graham and Nicole Wattelet, Forensic Accountant Crystal Boodoo, Assistant U.S. Attorney Anthony Saler, who handled forfeiture issues, and Assistant U.S. Attorney Jonathan Hooks, who is prosecuting the case.