Criminal Justice News

Tuesday, June 26, 2012

Houston Man Headed to Federal Prison for Health Care Fraud

HOUSTON—Kelvin Washington, 49, of Houston, has been handed a 24-month federal sentence following his convictions of health care fraud, conspiracy, and violations of the anti-kickback statute, United States Attorney Kenneth Magidson announced today. Washington was convicted after six days of trial and three-and-a-half hours of deliberation on December 8, 2011.

Today, U.S. District Court Judge Nancy Atlas, who presided over the trial, sentenced Washington to 24 months for each of the six convictions of health care fraud, conspiracy conviction, and three counts of violating the anit-kickback statute, all to be served concurrently. The court additionally ordered three years’ supervised release, of which the first 12 months of to be served as home confinement. He was ordered to pay approximately $480,000 in restitution to Medicare and Medicaid.

The evidence in the week-long trial showed that from 2003 to 2007, Washington received illegal payments for the referral of dialysis patients to a Houston ambulance transport service. In addition, he conspired with others to have unsuspecting doctors sign transport prescriptions for dialysis patients never admitted to a Sugar Land nursing home where he worked.

Testimony at trial showed Washington was paid for the referral of dialysis patients to an ambulance service that was under contract with the nursing home where he worked. The evidence also showed he would present prescriptions to doctors who worked at the nursing home. The doctors testified at trial that they would not have signed the prescriptions if they had known the various patients were never admitted to the nursing home.

The jury also heard evidence that the ambulance service paid the Washington in checks totaling $22,200 with many tied to specific patients. Washington did not report all the income he made to the Internal Revenue Service (IRS) from the ambulance service. At trial, an undercover video and audio tape showed one of the managers of the ambulance company bribing a patient to ride with the ambulance company. The ambulance company would later bill Medicare for this patient, a paid informant whose own doctors would not sign a prescription for him. The bill to Medicare was based upon a false script from Washington. In a search warrant executed on a co-conspirator’s home, “The List” was discovered, which detailed payments made not only to Washington but also to patients who rode with the ambulance service. A computer file from that home also showed detailed records tracking payments for patients, the check numbers for those payments, and the fact that payments were made to the defendant.

The false scripts alone resulted in $1.2 million billed to Medicare and Medicaid and approximately $480,000 paid.

Washington was permitted to remain on bond pending transfer to a U.S. Bureau of Prisons facility to be determined in the near future.

The charges are the result of the investigative efforts of Health and Human Services-Office of Inspector General, Office of Investigations; the Texas Attorney General’s Medicaid Fraud Unit; the FBI; and the United States Attorney’s Office. Special Assistant United States Attorney Suzanne Bradley and Assistant United States Attorney Al Balboni prosecuted the case.

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