Texas Patient Recruiter Sentenced to Nine Years in Prison for $3.6 Million Home Health Care Fraud Scheme

WASHINGTON – A Houston, Texas-area patient recruiter was sentenced to 108 months in prison today for her role in a $3.6 million Medicare fraud scheme involving fraudulent claims for home health services.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ryan K. 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’s (HHS-OIG) Dallas Region and the Texas Attorney General’s Medicaid Fraud Unit (MFCU) made the announcement.

Mercy O. Ainabe, 52, of Houston, was sentenced by U.S. District Judge Sim Lake of the Southern District of Texas, who presided over the trial.   After a three-day trial in May 2018, Ainabe was convicted of one count of conspiracy to commit health care fraud, five counts of health care fraud and one count of conspiracy to pay health care kickbacks.

According to evidence presented at trial, Ainabe, a long-time patient recruiter in the Houston area, controlled a substantial population of Medicare patients whose personal information she sold to home health care companies in exchange for kickbacks.  The evidence at trial showed that Ainabe and her co-conspirators used a home health care company called Texas Tender Care to submit claims to Medicare for home health services that were not medically necessary and/or were not provided.  Ainabe paid beneficiaries, doctors, physical therapy companies and others for the paperwork, Medicare beneficiary information and services needed to facilitate the fraud.  To cover up the fraud, Ainabe tried to make it look as though she was being paid an hourly wage as a legitimate marketing representative, the evidence showed.

The case was investigated by the FBI, HHS-OIG and MFCU, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas. The case is being prosecuted by Trial Attorneys Drew Pennebaker and Elizabeth Young of the Fraud Section.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  The Criminal Division’s Fraud Section leads the Medicare Fraud Strike Force.  Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in 12 cities across the country, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.