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MEDICAID FRAUD REPORT

National Association of Medicaid Fraud Control Units November/December 2010

INSIDE Operator of South Dakota Counseling Center is Sentenced ........................ 1 Cases ................................................ 2 Case Updates .................................. 13

Operator of South Dakota Counseling Center is Sentenced

Attorney General Marty Jackley announced on November 9 that Kim Michael Reid was sentenced to serve five years with three years suspended in the state penitentiary for committing Medicaid fraud. Reid pleaded guilty in August to one count of Making False Claims to Medicaid, pursuant to a plea agreement reached with the state. Reid admitted that he submitted false claims to Medicaid while operating Life Light Counseling, a drug and alcohol counseling center. The state revoked Life Light's accreditation and Reid surrendered his counselor certificate. Circuit Court Judge Timothy W. Bjorkman ordered Reid to pay restitution totaling $115,000 to the state. Reid paid $60,000 in restitution at his plea hearing in August. Reid must also pay a fine of $5,000, court costs of $104, and investigative costs of $1,485.58. The case was investigated and prosecuted by the South Dakota Medicaid Fraud Control Unit, with assistance from the U.S. Department of Health and Human Services Office of Inspector General, the Davison County State's Attorney, the Davison County Sheriff's Office, the Mitchell Police Department, the state Department of Social Services, and the U.S. Department of Human Services. For further information contact Paul Cremer, Director (605) 773-4102

Medicaid Fraud Report

November/December 2010

CASES Chemical Dependency Treatment Facilities: Texas Attorney General Greg Abbott announced on October 7 that Tony Nnonso Obi and Sunday Ekemezie Kanu were indicted by a state grand jury for aggregate theft by a government contractor. Obi and Kanu owned Standard Health Community Services, a chemical dependency treatment facility. They allegedly paid a marketer to provide patients and then billed Medicaid for chemical dependency counseling which was not provided. The identified Medicaid overpayment is more than $84,000. For further information contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. Counselors: Texas Attorney General Abbott announced on October 7 that Thomas and Jacqueline Freeman were indicted by a state grand jury for aggregate theft by a government contractor and Kenyetta Marshall was indicted for aggregate theft. Thomas, owner of a counseling facility J&T Behavioral Health, his wife, Jacqueline Freeman and step-daughter Kenyetta Marshall allegedly billed Medicaid for services not provided. **** Attorney General Abbott announced on October 12 that licensed professional counselor (LPC) Margie E. Hollingsworth was indicted by a state grand jury for Medicaid fraud. Hollingsworth allegedly billed Medicaid for services she did not provide. Records indicate that she lives in Colorado and provides her counseling by phone to patients throughout Texas. She is licensed in Texas and Colorado but does not bill for Medicaid in Colorado. **** Attorney General Abbott announced on October 12 that licensed professional counselor (LPC) Griselda Lozano pleaded guilty in federal court to health care fraud, making false statements relating to health care matters, and aggravated identity theft. Lozano received over $726,000 from Medicaid for counseling sessions she allegedly did not provide. For further information on these cases contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. Drug Diversion: Indiana Attorney Greg Zoeller announced on September 21 that Dr. Adolph Yaniz entered into a plea agreement with the U.S. Attorney's Office in the Northern District of Indiana. Dr. Yaniz agreed to plead guilty to two counts of dispensing a controlled substances, hydrocodone and alprazolam, without a legitimate medical purpose. Yaniz could receive up to five years imprisonment on each count. Yaniz also agreed to a lifetime debarment from any federally funded health benefit program and from seeking

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a license through the DEA to dispense controlled drugs. After Yaniz was arrested in this matter and his controlled substance dispensing license revoked, he recruited another physician, Dr. Jiroj Thephasdin to assist with his practice and to dispense controlled substances. The DEA investigated and found that Thephasdin had committed controlled substance violations while practicing with Yaniz. Attorney General Zoeller announced that Thephasdin had agreed with the U.S. Attorney's office to plead guilty to one count of illegal possession of a controlled substance. Thephasdin agreed to the same health benefit program sanctions as Yaniz and to not seek reinstatement of his DEA registration for five years. For further information contact Tim McClure, Deputy Director (317) 915-5335. Drug Diversion: Texas Attorney General Abbott announced on October 27 that licensed vocational nurse (LVN) Deanna Kay McFarlin was sentenced to five years probation and was fined $1,000 and ordered to enter a 180-day substance abuse program after pleading guilty in state court to obtaining a controlled substance by fraud. While employed at Trinity Mission Health & Rehabilitation, McFarlin allegedly diverted hydrocodone tablets from facility residents. For further information contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. Durable Medical Equipment: Texas Attorney General Abbott announced on October 7 that John Nasky Okonkwo pleaded guilty to health care fraud. He is the last to be convicted of 11 defendants involved with Onward Medical Supply, a durable medical equipment company owned by Doris Ngozi Vinitski. Vinitski, through Onward Medical Supply, billed Medicaid and Medicare for orthotic kits and wheelchairs that allegedly were not delivered or provided to recipients who did not qualify for the product. The loss to Medicaid is approximately $21,000 and the loss to Medicare is $190,000. Vinitski, John Remi Lachman, Michael Kalu Obasi, Ju-Ying Qian, Basil Obasi Kalu, Vicki Jackson Phillips, and Darnell Denese Willis previously pleaded guilty. Dr. Howard Grant, who allegedly provided fraudulent prescriptions, Obisike S Nwankwo, and Clifton Lee, Jr., were convicted by a federal jury. All 11 defendants are awaiting sentencing. **** Attorney General Abbott announced on October 13 that Xavier Alonzo Leal and Eloy Roel Leal were indicted by a state grand jury for Medicaid fraud and theft. Xavier Leal is the owner of All Valley DME, Inc. (AVD). His brother Eloy Leal was the biller. AVD allegedly dispensed products to Medicaid patients without physician's orders and billed for supplies not delivered. **** Attorney General Abbott announced on October 14 that Leroy Revis was indicted by a federal grand jury for conspiracy to commit health care fraud and health care fraud. Revis, a patient recruiter,

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allegedly received payment from Kate Olear, owner of Sefan Health Care Service for the referral of patients. Olear allegedly billed Medicaid and Medicare for products not delivered, upcoded products provided, and billed for products supposedly delivered to deceased beneficiaries. John Perry, MD, allegedly billed for patients he did not see and then signed fraudulent CMN's. Olear and Dr. Perry pleaded guilty in June to conspiracy to commit health care fraud. **** Attorney General Abbott announced on October 20 that Grover Franklin Poarch was indicted by a state grand jury for aggregate theft during a government contractual relationship. Poarch, owner/ operator of a DME company Franklin Medical Services (FMS), was convicted of wire fraud in 2001 in another healthcare fraud case and in October 2002, was excluded from all federal healthcare programs for 15 years. FMS billed Medicaid beginning in 2004 and was paid for power wheelchairs that allegedly were never provided. **** Attorney General Abbott announced on October 21 that James Claude Reese, Lia Samira St. Junius, Lily Zathel Johnson, Brenda Adriana Lopez, Martha Ramos, and Devon Spicer were indicted by a federal grand jury on multiple counts of healthcare fraud, kickbacks, money laundering, and conspiracy to commit healthcare fraud. All six subjects were associated with The Mobility Store (TMS), a durable medical equipment company. TMS allegedly billed for products, which it did not supply to patients; for products for patients who did not meet any medical necessity requirements; and, for products for which there were no CMNs created. TMS also allegedly paid kickbacks to marketers to sell products which TMS had never had in stock. For further information on these case contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. Home Health Care: Ohio Attorney General Richard Cordray announced on November 16 that Jamaica Sturgill pleaded guilty to one count of complicity to commit theft by deception, a misdemeanor of the first degree and was sentenced to suspended jail sentence of 30 days, and ordered to pay court costs in an amount to be determined. On March 16, an indictment was filed charging Jamaica with one count of complicity to commit theft by deception, a felony of the fourth degree. Sturgill, billed for services not rendered by the provider, however billed for services provided by a non-certified ineligible provider. For further information contact Senior Assistant Attorney General Shawn Napier (614) 4660722. Home Health Care Aides: Ohio Attorney General Cordray announced on November 9 that Mary Morgan pleaded guilty to one count of theft, a misdemeanor of the first degree and was sentenced to a suspended jail sentence

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of 180 days, two years probation, and ordered to pay restitution in the amount of $2,376. On May 18, an indictment was filed charging Morgan with two counts of theft, both felonies of the fifth degree. Morgan, a home health care aide billed for services not rendered. **** Attorney General Cordray announced on November 15 that Theadesa Mowen pleaded guilty to one count of theft by deception, a misdemeanor of the first degree and was sentenced to160 days in jail, which is suspended provided Mowen pays court costs in an amount to be determined and restitution in the amount of $1,371.96 in full. Mowen has seven days of jail credit. On May 18, an indictment was filed charging Mowen with one count of theft by deception, a felony of the fifth degree. Mowen, a home health care aide billed for services not rendered. For further information on both cases contact Principal Assistant Attorney General Jordan Finegold (614) 466-0722. **** Attorney General Cordray announced on November 22 that Randal Sturgill pleaded guilty to one count of theft by deception, a felony of the fifth degree and was sentenced to 12 months of community control, ordered to pay court costs in an amount to be determined, and pay restitution in the amount of $19,479.36. If Sturgill violates community control he will receive a prison term of six months. On March 16, an indictment was filed charging Sturgill with one count of theft by deception, a felony of the fourth degree. Sturgill, a home health care aide billed for services not rendered. For further information contact Senior Assistant Attorney General Shawn Napier (614) 4660722. **** Attorney General Cordray announced on November 23 that Leslie Nofsinger was sentenced to five years of community control, and ordered to pay restitution in the amount of $9,003.48. If Nofsinger violates community control she will receive a prison term of seven months. On June 15, an indictment was filed charging Nofsinger with one count of theft, a felony of the fourth degree. On October 4, Nofsinger pleaded guilty to one count of theft, a felony of the fifth degree. Nofsinger, a home health care aide, billed for services not rendered. For further information contact Senior Assistant Attorney General Constance Nearhood (614) 466-0722.

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Home Health Care Aides: Texas Attorney General Abbott announced on October 8 that Roseline Chinyere Nnawuihe was indicted by a state grand jury for tampering with a government record. Nnawuihe, former home health aide of A-Unified Home Health Agency (AUHHA), allegedly gave AUHHA falsified time sheets which supported services she purportedly provided to a client. For further information contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. Laboratories: Indiana Attorney General Zoeller announced on October 5 that a Chicago medical lab owner, Munir Chaudhry, pleaded guilty to six of the seven counts that he had been charged with in U.S. District Court. Chaudhry and Dr. Adolph Yaniz were charged last year on various counts of conspiring to defraud the U.S. government and aiding and abetting in health care fraud. Dr. Yaniz and Chaudhry, of Medway Diagnostic Laboratories, were indicted for conspiring to perform tests on the blood samples of Yaniz's patients that were not medically necessary. Medway Laboratories would then bill the Indiana Medicaid Program, Medicare or the patients' private insurance provider for the tests. The investigation also revealed that Medway paid for the rent on Yaniz's office building, and in exchange, Yaniz agreed not to mention the unnecessary tests to his patients. For further information contact Tim McClure, Deputy Director (317) 915-5335. Medical Transportation: Indiana Attorney General Zoeller announced on November 4 that Jose Amoa, principal of MEGA Transportation, pleaded guilty in federal court to one count of Medicaid fraud in district court. Amoa was sentenced to six months of monitored home detention, three years probation and was ordered to pay restitution in the amount of $36,713.51. Amoa waived his right to appeal. For further information contact Tim McClure, Deputy Director (317) 915-5335. Medical Transportation: Ohio Attorney General Cordray announced on November 22 that Fredrick Simpson pleaded guilty to one count of theft, a felony of the fifth degree. Simpson was sentenced to five years of community control, ordered to pay court costs in an amount to be determined, and ordered to pay restitution in the amount of $12,306.39. If Simpson violates community control he will receive a prison term of 12 months. On July 20, a bill of information was filed charging Simpson with one count of theft, a felony of the fifth degree. Simpson, owner of a transportation company, billed for transportation services

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that were not provided. For further information contact Senior Assistant Attorney General, Constance Nearhood (614) 466-0722. Medical Transportation: Texas Attorney General Abbott announced on October 13 that Nasir Muhammed Usman, owner of Royal Ambulance Service and First Choice EMS Ambulance, was sentenced in federal court to 15 years of incarceration and ordered to pay $1.2 million in restitution. Usman and operations managers, Shaun Jason Outen and David Ray McNac, were indicted for health care fraud, conspiracy to commit health care fraud, aiding and abetting, and money laundering. Usman was found guilty on all charges in a jury trial. Outen and McNac both pleaded guilty; their sentencing is pending. The three defendants allegedly directed the transportation of patients to dialysis facilities when those patients' medical conditions did not warrant such transportation. The alleged Medicaid fraud is over $498,000 and the Medicare fraud is over $4 million. For further information contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. Nurses: Arizona Attorney General Terry Goddard announced on October 19 that after pleading guilty to forgery, a class 4 felony, Taryn Paccioni was sentenced on August 16 to two years of supervised probation and ordered to pay restitution and investigative costs. The court determined the amount of restitution to victim would be $31,219.76. On February 12, 2009, Paccioni, a registered nurse at Fresenius Medical Care, had her license revoked. Allegedly, Paccioni failed to inform her employer that she had her license revoked. Paccioni had come in with her attorney to meet with the Arizona State Board of Nursing Executive Director in an attempt to overturn the revocation. It can be argued that she knew she was revoked and yet continued to practice nursing without a license. Prior to revocation, Paccioni had been on license probation for having engaged in drug diversion from health care facilities in Arizona. After she tested positive for drugs that she had not been prescribed, her probation was terminated and her license revocation went into effect. On February 22, Paccioni was indicted on one count of fraudulent schemes and artifices, one count of theft, and eleven counts of forgery. For further information contact Steven J. Duplissis, Director (602) 542-3881. Nurses: Colorado Attorney General John Suthers announced on November 2 that Christine Frances Mascarenas was sentenced in district court to one year probation following a plea of nolo contendere to a misdemeanor charge of controlled substance ­ failure to keep records. As part of the plea

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agreement, the MFCU moved to dismiss felony counts of fraud and deceit and false reports. Conditions of the sentence include 50 hours useful public service and a substance abuse evaluation and any treatment recommended. Mascarenas was working for a nursing facility as the director of nursing, when the state health department noticed a number of drugs that were listed as "destroyed" in her office in a sharp container. The matter was reported to the MFCU, who performed a detailed accounting of all of the controlled substances attributed to a number of patients. The MFCU concluded that the facility's drug destruction logs, completed by Mascarenas in conjunction with a consultant pharmacist, falsely recorded controlled substance destruction on several occasions. For further information contact Senior Assistant Attorney General George A. Codding or Investigator Bruce A. Norton (303) 866-5431. Nurses: Ohio Attorney General Cordray announced on November 18 that Kimberly Detlef pleaded guilty to one count of theft, a misdemeanor of the first degree and was sentenced to a six month suspended jail sentence, two years probation, and ordered to pay restitution in the amount of $2,877.46. On July 20, an indictment was filed charging Detlef with one count of theft, a felony of the fifth degree. Detleft, an LPN billed for more nursing services than were actually rendered. For further information contact Senior Assistant Attorney General Constance Nearhood (614) 466-0722. Nurses: Texas Attorney General Abbott announced on October 14 that licensed vocational nurse (LVN) Paula Ann Facklam was given five years deferred adjudication community supervision and fined $1,500. Facklam pleaded guilty in state court in September to two counts of possession of a controlled substance by fraud. Facklam was allegedly found unconscious by the nursing staff of Gulf Pointe Plaza Nursing Home and revived with CPR several times. She was later stopped by the sheriff's office and found in possession of Gulf Pointe Plaza resident narcotics. For further information contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. Nursing Homes: Alabama Attorney General Troy King announced on December 16 the conviction of a former employee of a nursing home for the theft of $20,174.56 while she was employed as the facility's business office manager. Marsha Kim Knighten pleaded guilty on December 15 before Judge William Shashy to 12 counts of second-degree forgery and one count of first-degree theft of property. Knighten admitted that, while employed at South Haven Health and Rehabilitation Center, she forged the signature of

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another employee on facility checks and then deposited the checks into her personal account. This activity occurred between August 2008 and November 2009. Knighten was indicted by a grand jury after management at the nursing home discovered the theft and reported it to the Attorney General's Medicaid Fraud Control Unit. She faces one to ten years imprisonment on each of the forgery convictions and two to twenty years on the theft conviction. For further information contact Gerald Shockley, Senior Special Agent or Bruce Lieberman, Director (334) 353-8793. Podiatrists: Kentucky Attorney General Jack Conway announced on October 22 that a grand jury indicted Dr. Richard E. Skrip, a podiatrist, on 23 felony counts of Medicaid Fraud. The indictment follows a criminal investigation conducted by the Medicaid Fraud and Abuse Control Unit into Skrip's billing practices. Skrip, who has offices in several locations in south central and south eastern Kentucky, is charged with defrauding the Kentucky Medicaid Program by submitting claims for payment of services totaling approximately $25,000. The indictment alleges Skrip submitted claims for services that he did not perform related to 26 patients between May 2001 and May 2008. For further information contact Mitchel T. Denham, Director (502) 696-5405. Resident Abuse: District of Columbia The District of Columbia Medicaid Fraud Control Unit announced on December 8 that James A. Little, Jr., a former employee of Innovative Life Solutions, a residential provider for persons with cognitive disabilities, was sentenced for assaulting a vulnerable person in his care. Little was found guilty on June 20 of assault after a trial before the Honorable Harold L. Cushenberry, Jr. in Superior Court. On December 7, the judge sentenced Little to 180 days in jail, with all days suspended except for 90 days, and one year of supervised probation. Judge Cushenberry also barred Little from working with the vulnerable population, and ordered him to attend anger management counseling, and to pay $50 towards the Victim of Violent Crime Compensation Act fund. According to testimony at trial, on January 19, Little was caring for the adult with cognitive disabilities. Witnesses who worked in the area where the assault occurred testified they saw the defendant use his hand to hit the victim two to five times about the head, shoulder, and hand. For further information contact Jacqueline Franklin, Investigator or Jacqueline N. Schesnol, Special Assistant U.S. Attorney (202) 727-8008.

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Resident Abuse: Kentucky Attorney General Conway announced on September 23 that five former caregivers at Communities of Oakwood were charged on September 22 with reckless abuse of a vulnerable adult and failure to report abuse following the abuse of a mentally disabled resident in August of this year. Charged in the case were Michael Whitaker, William Keene, Joshua Walters, Robert Carosello and Brandon Cameron. All are former caregivers at the intermediate care facility for persons with mental disabilities in Somerset. The complaints allege that on or about August 17, the defendants unreasonably confined a mildly mentally disabled resident in a room at Oakwood. Once inside the room, the defendants recklessly inflicted injuries on the victim including bruising to his torso and neck. None of the defendants notified the Cabinet of Health and Family Services of the suspected abuse immediately as required. Once the Oakwood administration became aware of the incident, approximately three days later, they sent the resident to the hospital and the Department of Community Based Services. Summonses were issued for all of the defendants and all were required to appear in district court. **** Attorney General Conway announced on October 29 the arrest of a former employee of Community Alternatives of Kentucky-Morehead on charges she sodomized a 24-year-old mentally disabled male resident. An investigator from the Medicaid Fraud and Abuse Control arrested Anne Marie Jones and charged her with sodomy 3rd degree, a felony. Jones was lodged in the Rowan County Detention Center. Community Alternatives of Kentucky, Inc. is a for profit company with several locations around the state. It provides residential services to mentally disabled individuals. Jones was a staff member at Community Alternative's Morehead facility at the time of the offense which is alleged to have occurred at one of the company's residential facilities within the past month. Jones resigned following a report of the alleged incident. Jones' arrest follows an investigation by the Medicaid Fraud and Abuse Control. Sodomy 3rd degree carries a potential sentence of one to five years in prison. **** Attorney General Conway announced on November 1 the guilty plea of a former mental health worker at Independent Opportunities for the mistreatment of a mentally challenged resident. The incident, which left the resident with minor injuries, occurred in September of 2009 at a Berea support for community living residence. Patsy Jackson pleaded guilty in district court to a charge of reckless abuse of a vulnerable adult. Jackson was sentenced to 90 days imprisonment, conditionally discharged for a period of two

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years as long as she commits no further criminal offenses. Under the terms of her guilty plea, Jackson is not permitted to work with vulnerable adults. She was also terminated from her position following the incident. A grand jury indicted Jackson in September following an investigation by the Medicaid Fraud and Abuse Control Unit. Independent Opportunities is a company that provides support and services to individuals with mental and developmental disabilities For further information on these cases contact Mitchel T. Denham, Director (502) 696-5405. Resident Abuse: Texas Attorney General Abbott announced on October 14 that William Jean Columb was indicted by a state grand jury for injury to a disabled individual. While employed with Bacon Community Home, Columb allegedly hit a resident, leaving marks on his head and forehead. For further information contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. Resident Neglect: District of Columbia The District of Columbia Medicaid Fraud Control Unit announced on November 3 that Micheline Ngouabou, a former employee of T & N Reliable Nursing Care (T & N), a staffing company, was sentenced for felony attempted robbery and misdemeanor criminal negligence of a vulnerable adult. Ngouabou pleaded guilty to attempted robbery and criminal neglect of a vulnerable adult and was sentenced on October 26 in Superior Court before the Honorable Jennifer Anderson. For the felony attempted robbery count, Judge Anderson sentenced the defendant to 18 months in prison, with all but six months suspended, and three years of supervised probation. For the misdemeanor criminal neglect of a vulnerable adult, Judge Anderson sentenced the defendant to 180 days in prison consecutive to the 18 months, with all days suspended, and three years of supervised probation to run concurrently with the felony probation. Additionally, the Court ordered Ngouabou not to work with vulnerable populations, and to pay $3,000 towards the Victim of Violent Crime Compensation Act fund. According to the government's evidence, the defendant worked as a home health side for T & N Reliable Nursing Care under a legitimate home health aide's name. In fact, Ngouabou used the other person's name, identification, and documents to gain employment at T & N. She falsely presented herself as that person and as a certified home health aide to T & N and the victim. Ngouabou worked at the home of a person with diabetes, kidney disease, and other ailments and who required assistance in his home. From March 2009 through August 2009, Ngouabou took

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cash left on the victim's nightstand as she gave him a sponge bath with his back turned to the nightstand. The victim noticed cash was missing at times that correlated to when Ngouabou was working at his home. The victim set up a recording device and captured images of her taking money. During the relevant time period, Ngouabou took more than $3,000 from the victim. Ngouabou also neglected to properly care for the patient, as she did not have any training or certification as a home health aide. Her negligence resulted in physical harm to the patient she was assigned to care for. For further information contact Special Assistant U.S. Attorney Jacqueline N. Schesnol (202) 727-8008. Resident Trust Funds: Arizona Attorney General Goddard announced on October 27 that Jennifer Campbell, a home health care assistant was sentenced after pleading guilty to financial exploitation of a vulnerable adult on September 7. Campbell was sentenced to three years probation under the supervision of the Adult Probation Department and ordered to pay restitution to the victim she was providing care to in the amount of $2,750. Campbell was assigned to assist a vulnerable adult, who has cerebral palsy, with daily tasks and errands. Campbell had access to the vulnerable adult's debit cards and pin numbers since he is physically unable to use ATM machines. Numerous unauthorized withdrawals were made on his two ATM cards. The Sheriff's Department obtained photos of Campbell making these transactions. The victim was able to identify the defendant and Campbell confessed to taking the ATM cards without consent and taking the money from the victim's accounts. On May 14, Campbell was indicted by a grand jury. She was charged with two counts of theft of a credit card, one count of fraudulent use of a credit card, and one count of financial exploitation of a vulnerable adult. For further information contact Assistant Attorney General Christina Vejar (520) 628-6362 Resident Trust Funds: Indiana Attorney General Zoeller announced on May 29 that the owner of a chain of group homes for developmentally disabled residents, Ernest M. Beal Jr., was sentenced to two years in prison, after he was convicted of the theft of approximately $75,000 in patient trust funds. After a Medicaid Fraud Control Unit investigation and trial, Beal was convicted of felony theft. Beal, is an attorney and was CEO of Your Friends & Neighbors, a company that operates group homes for the developmentally disabled in Indiana and Georgia. MFCU investigators reviewed allegations that between February 2006 and September 2008, Beal raided the trust funds of approximately 150 residents of his Indiana group homes and used the money for payroll ­ including his own. For further information contact Tim McClure, Deputy Director (317) 915-5335.

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Resident Trust Funds: South Carolina Attorney General Henry McMaster announced on December 8 that Benjamin F. Killingsworth, II was convicted of one count of exploitation of a vulnerable adult. During the period from about March 2005 and continuing until about May 2007, Killingsworth, while working as Administrator of Carriage House of Taylors, knowingly and willfully made improper, unlawful or unauthorized use of the funds or assets of vulnerable adults who were residents of Carriage House of Taylors Assisted Living Facility for the profit or advantage of Killingsworth or another person. Killingsworth was sentenced by the Honorable Robin Stillwell to three years suspended to three years probation with the condition that he make restitution in the amount of $20,000. For further information contact Assistant Deputy Attorney General C. William Gambrell, Jr., Assistant Attorney General William K. Moore, Senior or Special Investigator Thomas Holliday (803) 734-3660. Resident Trust Funds: Texas Attorney General Abbott announced on October 27 that Amber Christoffersen-Rogers and William Dale Rogers, Jr., pleaded guilty in state court to theft of property. Former Collinsville Care Center administrator Christoffersen-Rogers and office manager Rogers allegedly misappropriated over $8,000 from the resident trust and petty cash funds. For further information contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. CASE UPDATES Durable Medical Equipment: Texas Attorney General Abbott announced on October 4 that DME owner Noel W. Jhagroo was sentenced in federal court to 21 months in prison and three years supervised release and was ordered to pay $574,888.88 in restitution. Jhagroo, owner of Trucare Medical Equipment Services, pleaded guilty in November 2009 to conspiracy to commit health care fraud. (See: Medicaid Fraud Report, November/December 2009, p.4). Jhagroo and co-defendant licensed vocational nurse (LVN) Sylvia Smith were involved in an alleged scheme to bill Medicaid for medically unnecessary supplies and for enteral nutrition feeding supply kits that were never delivered. Smith was found guilty of healthcare fraud and conspiracy and was sentenced to 33 months in prison followed by three years supervised release and was ordered to pay $462,180.15 in restitution. The identified fraud is over $600,000. **** Attorney General Abbott announced on October 12 that Princewill Njoku pleaded guilty in federal court to conspiracy to commit health care fraud. Njoku and Clifford Ubani, owners of Family Healthcare Services, allegedly billed the accounts of Medicare beneficiaries for orthotic kits which they did not receive. Some beneficiaries received cheap substitute neoprene braces and/or received total orthotic kits which were not medically necessary. Ubani pleaded guilty in September to conspiracy to

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commit health care fraud and is awaiting sentencing. (See: Medicaid Fraud Report September/ October 2010, p. 20). Mary Lee Ellis, Michelle Sherri Turner, Rolandae Straughter, and Ana Quinteros were allegedly paid kickbacks for providing beneficiary information to Family Healthcare Services. Straughter and Quinteros pleaded guilty in March to conspiracy to commit health care fraud. (See: Medicaid Fraud Report, March/April 2010, p. 5). **** Attorney General Abbott announced on October 26 that durable medical equipment owner Tonye Dagogojack was given ten years deferred adjudication community supervision and was ordered to pay $137,441.51 in restitution and $3,000 in fines. Dagogojack pleaded guilty in September in state court to theft. (See: Medicaid Fraud Report, September/October 2010, p.5). Dagogojack, owner of Rightcare, allegedly billed Medicaid for incontinence care products that were not delivered. Dagogojack also did not report his felony conviction on his Medicaid and Medicare contract applications. Suspected Medicaid overpayments are over $633,000. For further information on these cases contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700. Home Health Care: Texas Attorney General Abbott announced on October 27 that home health nurse Cynthia Garza Williams pleaded guilty in federal court to conspiracy to commit health care fraud. Also, Sammie Wilson pleaded guilty to kickback violations and conspiracy to commit health care fraud. The two were involved with Clifford Ubani and Princewill Njoku, owners of Family HealthCare Services, and their respective wives, Ezinne and Caroline, who allegedly orchestrated a scheme to pay home health nurses or marketers for the re-certification of home healthcare patients. The Njoku's, Ubani's, Mary Ellis, and Michelle Turner were all charged with conspiracy to commit health care fraud, false statements and kickbacks. (See: Medicaid Fraud Report, September/October 2010, p. 20). Another group of defendants including Wilson, Aldema Sevilla, Florida Island, Margaret Pleasant, Estella Joseph, Terrie Porter and Erica Walker were indicted on October 7. Wilson is a beneficiary who was allegedly paid for accepting home health services and recruited other beneficiaries. Registered nurse Sevilla allegedly falsified home health nursing forms and was indicted for health care fraud. Island, Pleasant, Joseph, Porter and Walker allegedly accepted remuneration for supplying Family HealthCare Services with compromised beneficiary information and were also indicted for kickback violations. Wilson was indicted for health care fraud and kickbacks. This is a Houston Healthcare Fraud Strike Force and is being prosecuted by U.S. Department of Justice Strike Force attorneys in the U.S. Attorney's Office in Houston, Texas. For further information contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700.

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Psychiatrists: Texas Attorney General Abbott announced on October 6 that Rafael Solis, MD, was sentenced in federal court to five years probation and was ordered to pay $51,914.04 in restitution. Two other defendants in the case were sentenced in July (See: Medicaid Fraud Report September/October 2009, p. 2 and July/August 2010, p.21). Dr. Solis operated Synergy Counseling and allegedly billed Medicaid and Medicare for group therapy services that were not provided. For further information contact Rick Copeland, Director or Chief Investigator Jim Fossum (512) 371-4700.

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Inquires on editorial content should be addressed to: Barbara L. Zelner Executive Director National Association of Medicaid Fraud Control Units 2030 M Street NW, 8th Floor Washington, DC 20036 [email protected] Roy Cooper President National Association of Attorneys General D. Mark Collins President National Association of Medicaid Fraud Control Units James McPherson Executive Director National Association of Attorneys General

The views and opinions of authors expressed in this newsletter do not necessarily state or reflect those of the National Association of Attorneys General (NAAG). This newsletter does not provide any legal advice and is not a substitute for the procurement of such services from a legal professional. NAAG does not endorse or recommend any commercial products, processes, or services. Any use and/or copies of the publication in whole or part must include the customary bibliographic citation. NAAG retains copyright and all other intellectual property rights in the material presented in the publications. Copyright 2010, National Association of Attorneys General

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INDEX OF CASES

November/December 2010

CHEMICAL DEPENDENCY TREATMENT FACILITIES ............................................ 2 COUNSELORS Thomas and Jacqueline Freeman ............................................................................................. 2 Margie E. Hollingsworth ......................................................................................................... 2 Griselda Lozano ....................................................................................................................... 2 DRUG DIVERSION Deanna Kay McFarlin .............................................................................................................. 3 Dr. Adolph Yaniz ..................................................................................................................... 2 DURABLE MEDICAL EQUIPMENT Tonye Dagogojack ................................................................................................................. 14 Noel W. Jhagroo .................................................................................................................... 13 Xavier Alonzo Leal and Eloy Roel Leal .................................................................................. 3 Princewill Njoku .................................................................................................................... 13 Nasky Okonkwo....................................................................................................................... 3 Grover Franklin Poarch............................................................................................................ 4 Leroy Revis .............................................................................................................................. 3 James Claude Reese, Lia Samira St. Junis, Lily Zathel Johnson, Brenda Adriana Lopez, Martha Ramos, and Devon Spicer ........................................................................................... 4 HOME HEALTH CARE Jamaica Sturgill ........................................................................................................................ 4 Cynthia Garza Williams ......................................................................................................... 14 HOME HEALTH CARE AIDES Mary Morgan ........................................................................................................................... 4 Theadesa Mowen ..................................................................................................................... 5 Roseline Chinyere Nnawuihe .................................................................................................. 6 Leslie Nofsinger ....................................................................................................................... 5 Randal Sturgill ......................................................................................................................... 5 LABORATORIES .................................................................................................................. 6 MEDICAL TRANSPORTATION Jose Amoa ................................................................................................................................ 6 Fredrick Simpson ..................................................................................................................... 6 Nasir Muhammed Usman ........................................................................................................ 7 NURSES Kimberly Detlef ....................................................................................................................... 8 Paula Ann Facklam .................................................................................................................. 8 Christine Frances Mascarenas.................................................................................................. 7 Taryn Paccioni ......................................................................................................................... 7 NURSING HOMES ................................................................................................................ 8

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INDEX OF CASES

PODIATRISTS ....................................................................................................................... 9 PSYCHIATRISTS ................................................................................................................ 15 RESIDENT ABUSE William Jean Columb ............................................................................................................ 11 Patsy Jackson ......................................................................................................................... 10 Anne Marie Jones .................................................................................................................. 10 James A. Little Jr ..................................................................................................................... 9 Michael Whitaker, William Keene, Joshua Walters, Robert Carosello, and Brandon Cameron ........................................................................................................... 10 RESIDENT NEGLECT........................................................................................................ 11 RESIDENT TRUST FUNDS Ernest M. Beal Jr.................................................................................................................... 12 Jennifer Campbell .................................................................................................................. 12 Amber Christoffersen-Rogers ................................................................................................ 13 Benjamin F. Killingsworth..................................................................................................... 13

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