Tag Archives: HHS-OIG

Two Plead Guilty in Miami for Roles in $63 Million Mental Health Care Fraud Scheme

Posted on by
FOR IMMEDIATE RELEASE
Tuesday, November 20, 2012
Two Plead Guilty in Miami for Roles in $63 Million Mental Health Care Fraud Scheme
Two Health Care Professionals Pleaded Guilty This Week for Roles in Multi-State Scheme

WASHINGTON –A registered nurse pleaded guilty today and a former program coordinator pleaded guilty yesterday in connection with a health care fraud scheme involving defunct health provider Health Care Solutions Network Inc. (HCSN), announced Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Michael B. Steinbach, Acting 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 Investigations Miami office.

John Thoen, 53, of Miami, pleaded guilty today before U.S. District Judge Cecilia M. Altonaga in the Southern District of Florida to one count of conspiracy to commit health care fraud and one count of conspiracy to commit money laundering.  Alexandra Haynes, 36, of Taylor, S.C., pleaded guilty yesterday before Judge Altonaga to one count of conspiracy to commit health care fraud in the same case.

According to court documents, HCSN operated community mental health centers (CMHC) at three locations Miami-Dade County, Fla., and one location in Hendersonville, N.C.  HCSN purported to provide partial hospitalization program (PHP) services to individuals suffering from mental illness.  A PHP is a form of intensive treatment for severe mental illness.

According to an indictment unsealed on May 2, 2012, HCSN obtained Medicare beneficiaries to attend HCSN for purported PHP treatment that was unnecessary and, in many instances, not even provided.  HCSN obtained those beneficiaries in Miami by paying kickbacks to owners and operators of assisted living facilities.

According to court documents, Thoen was a licensed registered nurse in both Florida and North Carolina.  In Florida, Thoen participated in the admission to HCSN of patients who were ineligible for PHP services.  Thoen participated in the routine fabrication of patient medical records that were utilized to support false and fraudulent billing to government sponsored health care benefit programs, including Medicare and Medicaid.

In North Carolina, Thoen, according to court documents, routinely submitted fraudulent PHP claims for Medicare patients who were not even present at the CMHC on days PHP services were purportedly rendered.  Thoen also caused the submission of fraudulent Medicare claims on days the CMHC was closed due to snow.

Thoen also admitted to his role in a money laundering scheme, involving Psychiatric Consulting Network Inc. (PCN), a Florida corporation that was utilized by HCSN as a shell corporation to launder health care fraud proceeds.  According to court documents, Thoen was president of PCN.

According to court documents, Haynes was employed in Miami as an intake specialist and routinely fabricated patient medical records.  In North Carolina, Haynes was employed as a program coordinator and conducted group therapy sessions and fabricated corresponding group therapy notes even though she was not licensed to provide mental health services in the state.

According to court documents, from 2004 through 2011, HCSN billed Medicare and the Florida Medicaid program approximately $63 million for purported mental health services.

Nine defendants have been charged for their alleged roles in the HCSN health care fraud scheme.  Six defendants have pleaded guilty, and three defendants are scheduled for trial on Jan. 14, 2013, before U.S. District Judge Altonaga in Miami. Defendants are presumed innocent until proven guilty at trial.

The cases are being prosecuted by Special Trial Attorney William Parente and Trial Attorney Allan J. Medina of the Criminal Division’s Fraud Section.  This case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion.  In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

COVENTRY HEALTH CARE, INC. AGREES TO PAY $3 MILLION TO THE U.S. AS PART OF A NON-PROSECUTION AGREEMENT

Posted on by

COVENTRY HEALTH CARE, INC. AGREES TO PAY $3 MILLION TO THE U.S. AS PART OF A NON-PROSECUTION AGREEMENT

Unauthorized Access to Database Gave Coventry Unfair Advantage Over its Competitors

 

Baltimore, Maryland – Coventry Health Care, Inc. (Coventry) has agreed to pay the United States $3 million in return for the agreement by the United States Attorney’s Office for the District of Maryland not to prosecute Coventry criminally for any crimes arising from the unauthorized access by its employees to a Medicare database.

 

The agreement was announced by United States Attorney for the District of Maryland Rod J. Rosenstein and Special Agent in Charge Nicholas DiGiulio, Office of Investigations, Office of Inspector General of the Department of Health and Human Services.

 

Coventry provides group and individual health insurance to more than five million members in the United States. Coventry administers Medicare Advantage plans for some of its members, and some of its employees have access to the computerized database maintained by the Centers for Medicare and Medicaid Services (CMS) that contains Medicare eligibility information.

 

According to the agreement, from May 2005 to no later than December 29, 2006, some employees of Coventry and/or First Health Priority Services, a subsidiary, inappropriately accessed the Medicare database to obtain Medicare eligibility information for the sale of Medicare set-aside products. A Medicare set-aside is created from a process that allocates a portion of a worker’s compensation settlement to pay future medical expenses that would otherwise be payable by Medicare. Coventry’s actions were intended in part to give Coventry an unfair advantage over its competitors.

 

Several senior employees were aware of the unauthorized access to the Medicare database, including Coventry’s senior vice president for worker’s compensation services, senior vice president for government programs, senior vice president of service operations and the manager of Medicare enrollment department. All of these individuals have terminated their employment with Coventry.

 

In January 2007, the CMS contacted Coventry regarding the unauthorized access. Coventry acknowledged that employees had inappropriately accessed the database, and pledged to take corrective action.

In addition to the monetary settlement, Coventry has agreed to maintain new-hire and annual training for all of its employees who have been granted access to government databases, which include mandatory testing on fraud abuse, privacy and security.

 

United States Attorney Rod J. Rosenstein commended the investigative work performed by Office of Inspector General of the Department of Health and Human Services. The case was handled by Assistant U.S. Attorneys Tonya N. Kelly and Joyce K. McDonald.

Detroit-Area Nurse Sentenced to 30 Months in Prison for Role in $13.8 Million Home Health Care Fraud Scheme (CRM-FRD and USAO-EDMI)

Posted on by

Department of Justice
Office of Public Affairs
FOR IMMEDIATE RELEASE
Monday, November 19, 2012
Detroit-Area Nurse Sentenced to 30 Months in Prison for Role in $13.8 Million Home Health Care Fraud Scheme

WASHINGTON—A Detroit-area registered nurse was sentenced today to serve 30 months in prison for his role in a nearly $13.8 million Medicare fraud scheme, announced Assistant Attorney General Lanny A. Breuer 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.

Anthony Parkman, 41, of Southfield, Mich., was sentenced today by U.S. District Judge Gerald E. Rosen in the Eastern District of Michigan. In addition to his prison term, Parkman was sentenced to three years of supervised release and was ordered to pay $450,988 in restitution, jointly and severally with his co-defendants.

Parkman pleaded guilty on June 26, 2012, to one count of conspiracy to commit health care fraud.

According to Parkman’s plea agreement, beginning in approximately December 2008, Parkman, a registered nurse, was paid to sign medical documentation for Physicians Choice Home Health Care LLC, a home health agency that billed and received payments from Medicare for home health care services that were never rendered.  Parkman admitted to not seeing or treating the beneficiaries for whom he signed medical documentation and admitted he knew that the documents he signed would be used to support false claims to Medicare.  Parkman was paid approximately $150 for each false and fictitious file that he signed.

Parkman was subsequently paid to sign falsified medical documentation and files for First Care Home Health Care LLC, Quantum Home Care Inc. and Moonlite Home Care Inc., which were Detroit-area home health care companies owned by Parkman’s co-conspirators that billed Medicare for services that were never rendered.

The four home health companies for which Parkman worked were paid in total approximately $13.8 million by Medicare.  From approximately December 2008 through September 2011, Medicare paid approximately $450,988 to the four home health care companies for fraudulent skilled nursing claims based on falsified files signed by Parkman.

Nine of Parkman’s co-defendants have pleaded guilty and await sentencing.  Three co-defendants are fugitives, and six co-defendants await trial.

This case was prosecuted by Trial Attorney Catherine K. Dick of the Criminal Division’s Fraud Section.  It was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion.  In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

Program Director and Therapist from Miami-Area Mental Health Care Corporation Convicted for Participating in $205 Million Medicare Fraud Scheme

Posted on by
 11/16/2012

WASHINGTON – A federal jury yesterday convicted a Miami-area program director and a Miami-area therapist for their participation in a Medicare fraud scheme involving more than $205 million in fraudulent billings by mental health care corporation American Therapeutic Corporation (ATC), announced Assistant Attorney General Lanny A. Breuer of the Justice Department=s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Michael B. Steinbach, Acting 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 Investigations Miami Office.

Program director Lydia Ward, 47, and therapist Nichole Eckert, 35, were each found guilty of one count of conspiracy to commit health care fraud.

The defendants were charged in an indictment returned on Feb. 8, 2011. ATC, the management company associated with ATC and 20 individuals, including the ATC owners, have all previously pleaded guilty or have been convicted at trial.

Evidence at trial demonstrated that the defendants and their co-conspirators caused the submission of false and fraudulent claims to Medicare through ATC, a Florida corporation headquartered in Miami that operated purported partial hospitalization programs (PHPs) in seven different locations throughout South Florida and Orlando. A PHP is a form of intensive treatment for severe mental illness. The defendants and their co-conspirators also used a related company, American Sleep Institute (ASI), to submit fraudulent Medicare claims.

ATC billed Medicare for hundreds of millions of dollars in false and fictitious services, for thousands of patients who were not qualified, based on fraudulent documents created by Ward, Eckert and others.

Throughout the course of the fraud conspiracy, tens of millions of dollars in kickbacks were paid in exchange for Medicare beneficiaries, who did not qualify for PHP services, to attend treatment programs that were not legitimate PHP programs. ATC and ASI billed Medicare for more than $205 million in services to patients who did not need the services and to whom the appropriate services were not provided. According to the evidence, Ward, Eckert, and co-conspirators personally altered and caused the alteration of patient files and therapist notes for the purpose of making it appear, falsely, that patients being treated by ATC were qualified for PHP treatments and that the treatments provided were legitimate PHP treatments.

Evidence further revealed that doctors at ATC signed patient files without reading them or seeing the patients. Included in these false and fraudulent submissions to Medicare were claims for patients in neuro-vegetative states, along with patients who were in the late stages of diseases causing permanent cognitive memory loss and patients who were suffering from substance abuse addiction without a severe mental illness – all of whom were ineligible for PHP treatment.

Ward and Eckert were remanded into custody.

ATC executives Lawrence Duran, Marianella Valera, Judith Negron and Margarita Acevado were sentenced to 50 years, 35 years, 35 years and 91 months in prison, respectively, for their roles in the fraud scheme. Sentencing for Ward and Eckert is scheduled for Jan. 25, 2013. The maximum penalty for each conspiracy count is 10 years in prison.

A mistrial was declared today against ATC patient marketer Hilario Morris, who was charged with one count of conspiracy to commit health care fraud. Previously, Morris had been convicted of one count of conspiracy to pay health care kickbacks.

The criminal case is being prosecuted by Trial Attorneys Jennifer L. Saulino and Laura Cordova of the Criminal Division’s Fraud Section. A related civil action is being handled by Vanessa I. Reed and Carolyn B. Tapie of the Civil Division and Assistant U.S. Attorney Ted L. Radway of the Southern District of Florida. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

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

UTICA, NY Physician Indicted in $12 million Health Care Fraud Scheme

Posted on by

press release NDNY

Two Patient Recruiters Sentenced in Miami for Roles in $50 Million Medicare Fraud Scheme (USAO-SDFL)

Posted on by

Department of Justice

Office of Public Affairs
FOR IMMEDIATE RELEASE
Friday, November 16, 2012
11/16/2012: Two Patient Recruiters Sentenced in Miami for Roles in $50 Million Medicare Fraud Scheme (USAO-SDFL)

WASHINGTON – Two former patient recruiters for Miami-based mental health clinic Biscayne Milieu Health Care Inc. were sentenced today for their participation in a Medicare fraud scheme involving the submission of more than $50 million in fraudulent billings to Medicare, announced Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Michael B. Steinbach, Acting 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 Investigations Miami Office.

Anthony Roberts, 45, and Derek Alexander, 39, both of Miami, were each sentenced today by U.S. District Judge Robert N. Scola Jr. in the Southern District of Florida.  Roberts was sentenced to serve 87 months in prison and ordered to pay $887,085 in restitution.  Alexander was sentenced to serve 42 months in prison and ordered to pay $300,876 in restitution.

Roberts and Alexander were each convicted of one count of conspiracy to commit a health care kickback scheme and a substantive kickback charge on Aug. 24, 2012, after a two-month trial.

Various owners, doctors, managers, therapists, patient brokers and other employees of Biscayne Milieu were charged with various health care fraud, kickback, money laundering and other offenses in two indictments unsealed in September 2011 and June 2012.  Biscayne Milieu, its owners and more than 25 of the individual defendants charged in these cases have pleaded guilty or have been convicted at trial.  Antonio and Jorge Macli, and Sandra Huarte, the owners and operators of Biscayne Milieu, and Dr. Gary Kushner, its medical director, were each convicted of various offenses at trial and will be sentenced on Dec. 20, 2012.

Evidence at trial demonstrated that the defendants and their co-conspirators caused the submission of millions of dollars in false and fraudulent claims to Medicare through Biscayne Milieu, a Florida corporation headquartered in Miami that operated a purported partial hospitalization program (PHP) in Miami.  A PHP is a form of intensive treatment for severe mental illness.  Biscayne Milieu purported to provide PHP services for Medicare beneficiaries suffering from mental illnesses. In fact, however, the co-conspirators devised a scheme in which they paid patient recruiters, such as Roberts and Alexander, to refer ineligible Medicare beneficiaries to Biscayne Milieu for purported PHP services that were never provided. Many of the patients admitted to Biscayne Milieu were not eligible for PHP because they were chronic substance abusers, suffered from severe dementia or Alzheimer’s disease and would not benefit from group therapy, or had no mental health diagnosis at all but were seeking fraudulent mental health treatment in order to be declared exempt from certain requirements for their applications for United States citizenship.  The evidence at trial showed that Alexander and Roberts solicited and received illegal kickbacks in exchange for sending ineligible patients to Biscayne Milieu.

The criminal case was prosecuted by Assistant U.S. Attorneys Michael Davis and Marlene Rodriguez of the Southern District of Florida, and by Trial Attorney James V. Hayes of the Criminal Division’s Fraud Section.  The investigation was led by the FBI with the assistance of HHS-OIG, and was brought by the U.S. Attorney’s Office for the Southern District of Florida in coordination with the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

Chicago Psychiatrist Allegedly Submitted At Least 190,000 False Claims to Medicare and Medicaid; Lawsuit Alleges Kickbacks to Prescribe Antipsychotic Medication for Nursing Home Patients

Posted on by

press release NDIL

Mississippi Resident Pleads Guilty To Medicare Fraud Scheme Involving Power Mobility Devices

Posted on by

November 15, 2012

Memphis, TN – Tess Gurley Rouse, 41, of Corinth, Mississippi, pleaded guilty today to one count of defrauding Medicare of more than $368,000, announced United States Attorney Edward L. Stanton III.

Using her company, Eagle Eye Durable Medical Equipment in Counce, Tennessee, Rouse falsified claims electronically for Power Mobility Devices for Medicare beneficiaries in West Tennessee, North Mississippi and elsewhere. Many of the recipients would not have qualified for these devices under the criteria established by Medicare.

To further her scheme, Rouse supplied false documents including prescriptions, written orders, face-to face examinations, and detailed product descriptions purported to have the signature of the treating and referring physician.

Rouse is scheduled to be sentenced on March 21, 2013, at 1:30 p.m., by Judge J. Daniel Breen. She could receive up to 10 years in federal prison, up to a $250,000 fine, and be forced to pay restitution. There is no parole in the federal prison system.

These cases were investigated by the Department of Health and Human Services-Office of Inspector General. These cases were prosecuted by Assistant United States Attorney Stuart Canale on behalf of the government.

Indictment: Kidney Dialysis Patients Received Misbranded Drugs

Posted on by

TOPEKA, KAN. – A Tennessee pharmacist is charged with substituting a cheaper drug imported from China for the iron sucrose that the Federal Drug Administration has approved for kidney dialysis patients, U.S. Attorney Barry Grissom said today.

Robert Harshbarger, Jr., 53, Kingsport, Tenn., doing business as American Inhalation Medication Specialists, Inc., is charged with one count of selling misbranded drugs, one count of mail fraud and five counts of health care fraud.

The indictment alleges that as a result of fraud by Harshbarger kidney dialysis patients treated by Kansas Dialysis Services, L.C., received iron sucrose that had not been certified by the FDA to meet quality and safety standards.

“Although there are no reports of patient harm associated with the drugs that are alleged to be misbranded in this indictment, patient health was put at risk,” said U.S. Attorney Barry Grissom. “The FDA cannot assure the safety and effectiveness of products that are not FDA approved and come from unknown sources and foreign locations, or that may not have been manufactured under proper conditions. These unknowns put patients’ health at risk because of uncertainty concerning the product’s content, purity and source.”

Grissom said there is no reason for current or former patients of Kansas Dialysis to be concerned at this time. The events outlined in the indictment ended in 2009. Any significant iron deficiencies would have been addressed during the course of a patient’s dialysis treatments. Nevertheless, any questions should be addressed to a physician, Grissom said.

The indictment alleges that Harhbarger’s company, American Inhalation Medication Specialists, Inc., of Kingsport, Tenn., received more than $875,000 from Kansas Dialysis and more than $845,000 from health care benefit programs including Medicare and Medicaid for misbranded iron sucrose sold from 2004 to 2009. Harshbarger misrepresented the iron sucrose drug as Venofer, which is the only iron sucrose drug approved by the FDA for both pre-dialysis and post-dialysis patients.

Harshbarger purchased iron sucrose from Chinese companies including Qingdao Shenbang Chemical Company in Qingdao, China, and Shanghai Rory Fine Chemicals Co., Ltd., in Shanghai, China. The iron sucrose from China was cheaper than purchasing Venofer.

If convicted, Harshbarger faces a maximum penalty of 20 years in federal prison and a fine up to $250,000 on the mail fraud count; a maximum penalty of 10 years and a fine up to $250,000 on each of the health care fraud counts; and a maximum penalty of three years and a fine up to $250,000 on the charge of selling a misbranded drug. The Food and Drug Administration and the Dept. of Health and Human Services, Office of Inspector General, investigated. Assistant U.S. Attorney Tanya Treadway is prosecuting.

OTHER INDICTMENTS

Two men who were executives of the Brooke Companies, a now defunct insurance franchising business in Kansas, have been indicted on federal financial fraud charges.

Robert D. Orr, 59, Denver, Colo., and Leland G. Orr, 50, Phillipsburg, Kan., are charged with one count of conspiracy to defraud the Securities and Exchange Commission and three counts of making false statements in filings to the SEC. In addition, Robert Orr is charged with two more counts of making false statements in SEC filings and one count of bankruptcy fraud.

The Orrs were executives of Brooke Corporation, a holding company headquartered in Overland Park and Phillipsburg, Kan., that was engaged primarily in insurance franchising, insurance agency financing and banking. Brook Corporation owned a majority interest in Brooke Capital, Aleritas and Brooke’s Savings Bank. Brooke Capital sold insurance agency franchises and provided bookkeeping and other support services for franchises. Aleritas sold the majority of loans it made to franchisees and typically remained responsible for loan servicing. The companies were known collectively as the Brooke Companies.

The indictment alleges that in 2007 and 2008 the Brooke Companies experienced increasingly dire liquidity conditions and rapidly declining franchise financial health. In attempting to conceal financial problems, Brooke Companies’ management misrepresented the number of viable franchises, the health of Aleritas’ loan portfolio and other material financial information to the SEC, investors and lenders. They conspired to present a false aggregate picture of the Brooke Companies’ financial condition and thereby to obtain money, dividend payments and cash transfers for themselves.

If convicted, they face a maximum penalty of 20 years in federal prison and a fine up to $5 million on each count of making a false statement in SEC filings; and a maximum of five years and a fine up to $250,000 on each of the other counts. The FBI investigated. Assistant U.S. Attorney Mike Warner is prosecuting.

Bryan K. Carter, 32, Topeka, Kan., is charged with unlawful possession of a firearm after a felony conviction. The crime is alleged to have occurred Dec. 13, 2011, in Shawnee County, Kan.

If convicted, he faces a maximum penalty 10 years and a fine up to $250,000. The Bureau of Alcohol, Tobacco, Firearms and Explosives investigated. Assistant U.S. Attorney Duston Slinkard is prosecuting.

Omar Romero Salgado, 18, currently in custody in the Shawnee County Jail, is charged with one count of possession with intent to distribute methamphetamine, one count of possession with intent to distribute Clonazepam, one count of possession of a firearm in furtherance of drug trafficking and one count of possession of a stolen firearm. The crimes are alleged to have occurred Oct. 30, 2012, in Shawnee County, Kan.

If convicted, he faces a maximum penalty of 20 years and a fine up to $1 million on the methamphetamine charge; a maximum penalty of five years and a fine up to $250,000 on the Clonazepam charge; a penalty of not less than five years and a fine up to $250,000 on the charge of possessing a firearm in furtherance of drug trafficking; and a maximum penalty of 10 years and a fine up to $250,000 on the charge of possession of a stolen firearm. The FBI investigated. Assistant U.S. Attorney Jared Maag is prosecuting.

Xavier Patrick McCullough, 24, currently in custody in the Shawnee County Jail, and Ryan Cole Palmer, 25, currently in custody in the Shawnee County Jail, are charged with one count of possession with intent to distribute marijuana, one count of possession with intent to distribute methamphetamine and one count of possession of a firearm in furtherance of drug trafficking.

If convicted, they face a maximum penalty of 20 years and a fine up to $1 million on the methamphetamine charge; not less than five years and a fine up to $250,000 on the firearm charge; and a maximum penalty of five years and a fine up to $250,000 on the marijuana charge. The Topeka Police Department and the FBI investigated. Assistant U.S. Attorney Jared Maag is prosecuting.

In all cases, defendants are presumed innocent until and unless proven guilty. The indictments merely contain allegations of criminal conduct.

DME Owner Convicted of Health Care Fraud and Aggravated Identity Theft

Posted on by

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.