Tag Archives: HHS-OIG

Mental Health Service Provider Sentenced to 48 Months for Conspiracy to Commit Health Care Fraud

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11/13/2012

RICHMOND, Va. – Joseph T. Hackett, 32, of Asheville, N.C., was sentenced today to 48 months in prison, followed by a term of three years of supervised release, for Conspiracy to Commit Health Care Fraud. He also agreed to forfeit $1,570,041.60 and pay $1,570,041.60 in restitution to the Virginia Department of Medical Assistance Services.

Neil H. MacBride, United States Attorney for the Eastern District of Virginia; and Kenneth T. Cuccinelli, Attorney General of Virginia, made the announcement after sentencing by United States District Judge Henry E. Hudson. Hackett pled guilty on August 13, 2012.

According to Court documents, Hackett owned and operated Access Regional Taskforce (“ART”), a Richmond-based Medicaid contracted provider of Intensive In-home Therapy Services for children and adolescents. Intensive In-home Therapy Services, one of the many mental health services offered by Medicaid in Virginia, are designed to assist youth and adolescents who are at risk of being removed from their homes, or are being returned to their homes after removal, because of significant mental health, behavioral, or emotional issues. Medicaid requires that Intensive In-home Therapy Service providers employ qualified mental health workers to provide a medically necessary service to at-risk children and adolescents.
In a statement of facts filed with the plea agreement, Hackett acknowledged that, through ART, he billed Medicaid for services that were not reimbursable because the services did not address a child’s specific mental health issues, were not provided by qualified mental health workers, and were not provided to children who were in actual need of the offered service. Hackett acknowledged that Medicaid paid ART at least $1,570,041.60 that ART was not entitled to receive. In addition, he admitted in the statement of facts that Hackett paid Creed Xtreme Marketing Concepts, a.k.a. Creed Extreme Marketing, $545,410.00 for patient referrals. The owner of Creed, Lorie T. Monroe, was sentenced on June 12, 2012 to 37 months of imprisonment for receiving these referral payments.
The case was investigated by the Virginia Attorney General’s Medicaid Fraud Control Unit and the Federal Bureau of Investigation, with assistance from the Virginia Department of Medical Assistance. Special Assistant United States Attorney Joseph E.H. Atkinson and Assistant United States Attorney Jessica Aber Brumberg prosecuted the case on behalf of the United States.

A copy of this press release may be found on the website of the United States Attorney’s Office for the Eastern District of Virginia at http://www.justice.gov/usao/vae. Related court documents and information may be found on the website of the District Court for the Eastern District of Virginia at http://www.vaed.uscourts.gov or on https://pcl.uscourts.gov.

Owner of Chantilly Pain Clinic Sentenced to 180 Months for Drug-Trafficking, Fraud Charges

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11/9/2012

ALEXANDRIA, Va. – Paul Boccone, 56, was sentenced today to 180 months in prison, followed by three years of supervised release, for turning his Chantilly-based pain clinic into a haven for drug addicts, servicing thousands of customers traveling hundreds of miles to illegally obtain large amounts of oxycodone and other prescription pain medicine. Charles Brown, Jr., 52, the lead nurse practitioner at Chantilly Specialists, was also sentenced today to 60 months in prison, followed by three years of supervised release, for his role in distributing oxycodone.

Neil H. MacBride, United States Attorney for the Eastern District of Virginia; Kenneth T. Cuccinelli, Attorney General of Virginia; James W. McJunkin, Assistant Director in Charge of the FBI’s Washington Field Office; Richard A. Raven, Special Agent in Charge of the Washington Field Office of IRS-Criminal Investigation; and Nick DiGuilio, Special Agent in Charge for the Inspector General’s Office of the United States Department of Health and Human Services in Philadelphia, made the announcement after sentencing by United States District Judge Claude M. Hilton.

Boccone was convicted on Aug. 3, 2012, of conspiring to distribute and distributing oxycodone, healthcare fraud, and payroll tax evasion. According to court records and evidence at trial, Boccone was the owner and president of Chantilly Specialists, a pain management clinic in Chantilly, Va. Lacking any medical education, qualifications, or licensing, Boccone hired medical professionals with no background or specialized training in pain management. He treated patients and prescribed narcotics by directing medical practitioners to endorse prescriptions that he wrote.

Over the course of the conspiracy, evidence showed that at least four Chantilly Specialists patients died of overdoses related to the drugs they obtained from the practice. Brown, at Buccone’s direction, altered one of the patient’s files after Chantilly Specialists learned of that patient’s death.

Evidence showed that Brown provided 600 customers more than 800,000 oxycodone-based pills, including 14,400 to a single addict.

This case was investigated by the FBI Washington Field Office; IRS-Criminal Investigation; and the Department of Health and Human Services’ Office of the Inspector General, with assistance from the Fairfax County Police Department.

Assistant United States Attorney Michael P. Ben’Ary and Special Assistant United States Attorney and Virginia Assistant Attorney General Marc J. Birnbaum are prosecuting the case on behalf of the United States.

A copy of this press release may be found on the website of the United States Attorney’s Office for the Eastern District of Virginia at http://www.justice.gov/usao/vae. Related court documents and information may be found on the website of the District Court for the Eastern District of Virginia at http://www.vaed.uscourts.gov or on http://pacer.uspci.uscourts.gov.

Indictments Returned in Hammond Federal Court (USAO-NDIN)

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HAMMOND, IN—The United States Attorney’s Office announced that the following Indictments were returned on November 8, 2012:

  • Hoosier EMS Roy Dunn, 59, and Kahley Vergon-Mayotte, 27, both of Winimac, Indiana; and Anthony Bitterling, 39, of Monticello, Indiana, were charged in an indictment with conspiracy to commit health care fraud. These charges were filed as the result of an investigation by the Federal Bureau of Investigation, the United States Department of Health and Human Services, and the Indiana Medicaid Fraud Control Unit. This case has been assigned to and will be prosecuted by Assistant United States Attorney Diane Berkowitz.
  • Edwin Tollinchi-Rodriguez, 27, of East Chicago, Indiana, was charged in an indictment with aggravated sexual abuse. This case resulted from an investigation by members of the Indiana Internet Crimes Against Children Task Force, including the Federal Bureau of Investigation; the East Chicago Police Department; and the Lansing, Illinois Police Department. This case has been assigned to and will be prosecuted by Assistant United States Attorney Jill Koster.
  • Kevin Paul Brewster, 40, of Portage, Indiana, was charged in an indictment with four counts of production of child pornography, one count of receipt of child pornography, and one count of possession of child pornography. This case resulted from an investigation by members of the Indiana Internet Crimes Against Children Task Force, including the Federal Bureau of Investigation and the Portage Police Department. This case has been assigned to and will be prosecuted by Assistant United States Attorney Jill Koster.
  • Austin Nwaka, dba Service Above Self, of Canby, Indiana, and Phyllis Lark, dba Absolute Care, of Hammond, Indiana, were charged in an indictment with health care fraud. Lark was also charged with making false statements to a federal agent. These charges were filed as the result of an investigation by the Federal Bureau of Investigation and the Indiana Medicaid Fraud Control Unit. This case has been assigned to and will be prosecuted by Assistant United States Attorney Diane Berkowitz.
  • Daron Moten, 23, of Gary, Indiana, was charged in an indictment with possession of a firearm by a convicted felon. These charges were filed as the result of an investigation by the by the Bureau of Alcohol, Tobacco, Firearms, and Explosives and the Gary Police Department. This case has been assigned to and will be prosecuted by Special Assistant United States Attorney Armando Salinas, Jr.
  • Michael J. Plake, 47, of Lafayette, Indiana, and Paul Cardwell, 46, formerly of Monticello, Indiana, were charged in an indictment with conspiracy to commit mail fraud. These charges were filed as the result of an investigation by the Federal Bureau of Investigation. This case has been assigned to and will be prosecuted by Assistant United States Attorney Diane Berkowitz.

The United States Attorney’s Office emphasized that an indictment is merely an allegation and that all persons charged are presumed innocent until and unless proven guilty in court.

If convicted in court, any specific sentence to be imposed will be determined by the judge after a consideration of federal sentencing statutes and the Federal Sentencing Guidelines.

Detroit-area Physician Sentenced to 60 Months for Health Care Fraud (USAO-EDMI)

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11/6/2012

Jonathan Agbebiyi, 63, of Sterling Heights, Michigan, was sentenced yesterday for his role in a $5.4 million Medicare fraud scheme, announced United States Attorney Barbara L. McQuade. McQuade was joined in the announcement by Assistant Attorney General Lanny A Breuer of the Criminal Division in Washington, DC, Special Agent-In-Charge, Robert Foley, III, Federal Bureau of Investigation and Special Agent in Charge Lamont Pugh III of the Health and Human Services – Office of Inspector General’s (OIG) Chicago Regional Office.

Agbebiyi was sentenced by United States District Judge Arthur J. Tarnow to 60 months in prison, followed by 2 years supervised release, and ordered to pay $2,982,029.19 in restitution.

In May, 2012, Jonathan Agbebiyi, 63, of Sterling Heights, Michigan, was convicted of one count of conspiracy to commit health care fraud, and six counts of health care fraud. Agbebiyi was a staff physician at three clinics which operated in Livonia, Michigan, between 2007 and 2010: Blessed Medical Clinic, Alpha and Omega Medical Clinic, and Manuel Medical Clinic.

According to the evidence presented during the one week trial, Jonathan Agbebiyi, an obstetrician/gynecologist, joined a conspiracy to bill Medicare for medically unnecessary neurological tests. Some of the tests involved sending an electrical current through the arms and legs of the patients. Clinic employees, who lacked any meaningful training, administered the diagnostic tests. The patients never received any follow up treatment by neurologists.
Evidence at trial showed that the patients were not referred to the clinics by their primary care physicians, or for any other legitimate purpose, but rather were recruited with prescriptions for controlled substances, cash payments, and fast food. The three clinics then billed the Medicare program for various diagnostic tests that were medically unnecessary.

United States Attorney Barbara L. McQuade stated, “This doctor exposed patients to electrical currents for neurological testing solely to generate money for himself at the expense of the Medicare program. We hope that cases like this one will deter other doctors from using patients as commodities for personal gain.”

This case was prosecuted by Assistant U.S. Attorneys Frances Lee Carlson and Philip A. Ross of the Eastern District of Michigan, with assistance from Assistant Chief Gejaa T. Gobena of the Criminal Division’s Fraud Section. 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 Eastern District of Michigan.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 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.
Since their inception in March 2007, strike force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.