NEW ORLEANS – U.S. Attorney Peter G. Strasser announced
today the sentencing of four local physicians, a biller, and office manager
following a four week trial that ended on May 9, 2017.
Specifically, HENRY EVANS, age 74, was found guilty of five
counts of health care fraud; MICHAEL JONES, age 49; PAULA JONES, age 45;
SHELTON BARNES, age 63; GREGORY MOLDEN, age 60, all of New Orleans; and
JONATHON NORA, age 31, of River Ridge, were all found guilty of conspiracies to
commit health care fraud and to receive and pay health care kickbacks, and
health care fraud. BARNES, MICHAEL JONES, MOLDEN, and NORA were also found
guilty of individual counts of health care fraud. Additionally, BARNES was found guilty of
obstruction of a federal audit.
The Second Superseding Indictment rises out of an Indictment
returned in March 2015 charging Abide owner, Lisa Crinel, and others with
health care fraud. Nineteen individuals and/or companies pleaded guilty before
trial to charges associated with the original Indictment.
According to the Second Superseding Indictment, the
defendants fraudulently billed Medicare for medically unnecessary home health
services for patients who were not homebound. BARNES, EVANS, MOLDEN, and
MICHAEL JONES, known as “House Doctors,” ordered home health services for
Medicare beneficiaries who had no legitimate medical necessity. The House Doctors falsely signed home health
orders regardless of the beneficiaries’ needs, homebound status, or
diagnoses. In return, BARNES, EVANS, and
MOLDEN received illegal monthly payments characterized as medical consultant or
director fees for which they provided no services other than fraudulently
certifying Medicare beneficiaries for unnecessary home health services. Instead of receiving monthly payments from
the home health agency, Abide hired PAULA JONES, MICHAEL JONES’ wife and,
thereafter, inflated salary payments to PAULA JONES in order to pay MICHAEL
JONES’ fees for fraudulently certifying ineligible Medicare beneficiaries.
Marketers contacted JONATHON NORA and others to confirm that
the person fraudulently referred for home health was a Medicare beneficiary.
Once NORA determined that the referred individual was a Medicare beneficiary,
NORA scheduled a physician visit, usually with an Abide House Doctor, well
knowing that the individual referral to Abide was by a Marketer, instead of the
beneficiary’s own health care professional.
Abide generated plans of care reflecting the falsely created
assessments. The plans of care were given to BARNES, EVANS, MOLDEN, and MICHAEL
JONES to falsely certify and recertify medically unnecessary episodes of home
health. PAULA JONES fraudulently billed Medicare, on behalf of Abide, for the
medically unnecessary home health services.
U.S. District Judge Susie Morgan sentenced SHELTON BARNES,
age 64, to sixty (60) months imprisonment, followed by one (1) year of
supervised release, and restitution in the amount of $10,850,229 to be paid to
Medicare.
Judge Morgan sentenced HENRY EVANS, age 74, to fifty (50) months
imprisonment, followed by one (1) year of supervised release, and restitution
in the amount of $1,262,043 to be paid to Medicare.
Judge Morgan sentenced GREGORY MOLDEN, age 62, to
forty-eight (48) months imprisonment, followed by one (1) year of supervised
release, and restitution in the amount of $626,405 to be paid to Medicare.
Judge Morgan sentenced MICHAEL JONES, age 49, to thirty-six
(36) months imprisonment, followed by two (2) years of supervised release, and
restitution in the amount of $347,525 to be paid to Medicare.
Judge Morgan sentenced PAULA JONES, age 45, to one year and
one day imprisonment, followed by three (3) years of supervised release, and
restitution in the amount of $3,106,954 to be paid to Medicare. Upon her release from imprisonment, PAULA
JONES was ordered to serve a term of home detention for a period of 24 months.
Judge Morgan sentenced JONATHON NORA, age 31, to forty (40)
months imprisonment, followed by one (1) year of supervised release, and
restitution in the amount of $12,921,797 to be paid to Medicare.
U.S. Attorney Strasser praised the work of the Special
Agents of the Federal Bureau of Investigation and the United States Department
of Health and Human Services, Office of Inspector General in investigating this
matter. Assistant U.S. Attorneys Patrice Harris Sullivan, Sharan Lieberman,
Maria Carboni, and Andre Lagarde prosecuted the case.
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