Two Houston, Texas
physicians were sentenced to 25 and three-year prison terms for their roles in
separate schemes to defraud Medicare out of payments for medical services.
Assistant Attorney General Brian A. Benczkowski of the
Justice Department’s Criminal Division, U.S. Attorney Ryan Patrick of the
Southern District of Texas, Special Agent in Charge Perrye K. Turner of the
FBI’s Houston Field Office, Special Agent in Charge C.J. Porter of the U.S.
Department of Health and Human Services Office of Inspector General (HHS-OIG)
Dallas Region and the Texas Attorney General’s Medicaid Fraud Control Unit
(MFCU) made the announcement.
US v. Ramirez S.D.T.X. Docket No. 16-cr-00258
John P. Ramirez, 65, of Houston, Texas, a physician, was
sentenced to serve 25 years in prison followed by three years of supervised
release by U.S. District Judge David Hittner of the Southern District of
Texas. Judge Hittner also ordered the
defendant to pay $26,729,041.39 in restitution.
John Ramirez was convicted at trial in the Southern District of Texas
along with his co-defendants Ann Shepherd and Yvette Nwoko.
According to evidence presented at trial, from in or around
December 2011 to in or around August 2015, John Ramirez and his co-defendants
conspired and schemed to defraud Medicare out of payments for medical
services. Co-defendant Ann Shepherd
owned and operated Southwest Total Medical Inc., a purported medical clinic
doing business as Amex Medical Clinic in Houston. Shepherd, along with Nwoko, sold medical
orders and other documents Dr. Ramirez signed to home-health agencies in and
around Houston. Dr. Ramirez falsely
certified in these medical orders information about the patient’s medical
condition and need for medical services.
Co-conspirators at home-health agencies then used the false and
fraudulent paperwork signed by Dr. Ramirez and sold by Ann Shepherd and Yvette
Nwoko to bill to, and receive payment from, Medicare for medical services that
were not medically necessary or not provided.
In all, Dr. Ramirez and his co-defendants caused Medicare to
pay approximately $17 million on false and fraudulent claims submitted during
the charged conspiracy.
Ann Shepherd, 62, of Houston, Texas was also sentenced to 30
years in prison on Jan. 24, by the Honorable David Hittner. Judge Hittner also ordered Shepherd to pay
$20.928 million in restitution and to forfeit $250,000. Nwoko will be sentenced on April 18.
U.S. v. Do S.D.T.X.
Docket No. 17-cr-00417
Anh Do, M.D., 78, of Houston, Texas was sentenced to serve
36 months in prison followed by three years of supervised release by U.S.
District Judge Andrew Hanen of the Southern District of Texas. Judge Hanen also ordered the defendant to pay
$1,875,219.00 in restitution and to forfeit $274,213.46. Do pleaded guilty to one count of conspiracy
to commit healthcare fraud on Aug. 28, 2018.
As part of his guilty plea, Do admitted to fraudulently
signing Plans of Care and other medical documents that falsely and fraudulently
certified and re-certified patients for home-health services. Do and his co-conspirators made it appear as
if patients qualified for and received home-health services under Medicare when
those services were not medically necessary, not provided or both. Medicare
paid approximately $10 million on claims for home-health services in which Do
was listed as the patient’s attending physician.
Do and his co-conspirators also billed Medicare for
diagnostic tests that they knew were not medically necessary, not provided or
both. Do and his co-conspirators falsely
and fraudulently signed medical documents to make it appear as if the patients
both needed and received the diagnostic tests.
Medicare paid approximately $2 million on claims for these diagnostic
tests.
The FBI, HHS-OIG and the Texas Attorney General’s MFCU
conducted both investigations. Trial
Attorney Scott Armstrong of the Criminal Division’s Fraud Section and Assistant
U.S. Attorney Tina Ansari of the Southern District of Texas are prosecuting the
Ramirez case. Trial Attorneys Devon
Helfmeyer, Scott Armstrong and Drew Pennebaker of the Criminal Division’s Fraud
Section are prosecuting the Do case.
The Criminal Division’s Fraud Section leads the Medicare
Fraud Strike Force. Since its inception
in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike
forces operating in 23 districts, has charged nearly 4,000 defendants who have
collectively billed the Medicare program for more than $14 billion. In addition, the HHS Centers for Medicare
& Medicaid Services, working in conjunction with the HHS-OIG, are taking
steps to increase accountability and decrease the presence of fraudulent
providers.
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