Friday, March 23, 2012

Baton Rouge-Area Residents Sentenced in Medicare Fraud Scheme


WASHINGTON—Two patient recruiters for several Louisiana durable medical equipment (DME) companies were sentenced today for their roles in Medicare fraud schemes involving false claims and illegal kickback payments for unnecessary DME, announced the Department of Justice, the Department of Health and Human Services (HHS), the FBI, and the Louisiana State Attorney General’s Office.

Stephanie B. Williams and Mary H. Griffin were sentenced by U.S. District Judge James J. Brady of the Middle District of Louisiana to 48 months and 21 months in prison, respectively. Williams was ordered to pay $4 million in restitution, and Griffin was ordered to pay $3.6 million in restitution. In addition, Judge Brady sentenced the defendants to two years of supervised release following their prison terms. Williams pleaded guilty on December 13, 2011, and Griffin pleaded guilty on October 31, 2011.

Williams and Griffin worked as recruiters for Healthcare 1 LLC, Medical 1 Patient Services LLC, and Lifeline Healthcare Services Inc., Louisiana-based companies that fraudulently billed medical equipment to the Medicare program from 2004 to 2009. They and other recruiters were hired to obtain prescriptions for medical equipment such as leg braces, arm braces, power wheelchairs, and wheelchair accessories. Williams and Griffin obtained information from Medicare beneficiaries as well as prescriptions for medical equipment from the beneficiaries’ physicians. These prescriptions were then used to submit fraudulent claims to the Medicare program. In addition, Griffin participated in a similar scheme at McKenzie Healthcare Solutions Inc., where she was paid kickbacks and caused the submission of fraudulent claims for medically unnecessary DME from 2005 to 2010.

According to court documents, from 2004 to 2010, the companies involved in these schemes submitted more than $30 million in fraudulent billing.

Today’s sentences were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Donald J. Cazayoux, Jr. of the Middle District of Louisiana; Mike Fields, Special Agent in Charge of the Dallas Region for the HHS Office of the Inspector General (HHS-OIG); David Welker, Special Agent in -Charge of the FBI’s New Orleans Division; and James Buddy Caldwell, Louisiana State Attorney General.

The cases were prosecuted by Assistant Chief William Pericak; Trial Attorneys David Maria, Abigail Taylor, and Alexander Berlin; and former Assistant Chief Ben Curtis of the Criminal Division’s Fraud Section. The cases were investigated by the FBI, HHS-OIG, and the Medicaid Fraud Control Unit of the Louisiana State Attorney General’s Office (MFCU) and were 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 Middle District of Louisiana.

Since its inception in March 2007, the Medicare Fraud Strike Force operations in nine locations have charged more than 1,190 defendants that collectively have billed the Medicare program for more than $3.6 billion. In addition, HHS’s 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.

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

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