Jury Finds Four New Orleans Doctors and Others Guilty for Participation in $13.6 Million Medicare Fraud Scheme

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On May 9, 2017, a federal jury found four New Orleans doctors and two others guilty for their participation in a Medicare fraud scheme. According to prosecutors the defendants netted more than $13.6 million in fraudulent Medicare reimbursements.

Details of the Scheme.

The six defendants worked for or with Abide Home Care Services (Abide) in New Orleans. Federal prosecutors said Abide routinely falsified diagnoses so Medicare reimbursements were inflated. Abide also falsified medical records that supported medically unnecessary home health services, prosecutors said. Abide was owned by Lisa Crinel, who pleaded guilty to her role in the scheme in 2015.

In exchange for their role in the scheme, Abide made monthly payments to the doctors that were falsely characterized as medical consultant or director fees. Abide also hired Dr. Michael Jones’ wife Paula Jones and inflated her salary payments to pay for fraudulently certifying documents. Additionally, Jonathan Nora scheduled doctor visits with Abide “well knowing” that the referral did not come from the beneficiary’s own health care professional.

The Trial.

After a month long trial, a federal jury returned guilty verdicts against the six individuals charged with committing Medicare fraud. Found guilty were Dr. Henry Evans, Dr. Michael Jones and his wife Paula Jones, Dr. Shelton Barnes, Dr. Gregory Molden and Jonathon Nora. Click here to read the press release issued by Acting U.S. Attorney Duane Evans’s Office in Eastern District of Louisiana.

The Consequences.

Dr. Evans was found guilty of five counts of health care fraud. Dr. Michael Jones, Paula Jones, Dr. Barnes, Dr. Molden and Jonathan Nora each were found guilty of conspiracies to commit health care fraud, defrauding the United States, receiving and paying kickbacks and health care fraud, according to the U.S. Attorneys Office. The four doctors and Nora were convicted of additional individual counts of health care fraud. Dr. Shelton Barnes was additionally convicted of obstruction of a federal audit.

Dr. Barnes faces a maximum penalty of up to 170 years in federal prison; Dr. Molden faces up to 115 years; Dr. Michael Jones faces up to 95 years; Dr. Evans faces up to 50 years in federal prison; Paula Jones faces up to 15 years; and Nora faces up to 25 years. Each also faces a maximum fine of up to $250,000 for each count.

Doctors Beware.

In our practice we have represented a number of doctors who have been exploited by nonphysicians intent on committing fraud. They will often target older and semi-retired physicians. The goal is merely to get their name and identification number to use in falsifying medical records and claims. If the deal you are being offered seems like too good of a deal, involves little or no work on your part to receive a large check each month or involves working for nonphysicians or individuals you do not know, you should beware. Always know who you are working for, the location of their actual place of business and residence, and with whom (physician-wise) they have done business before. You do not want to spend the later years of your life in prison, after pursuing an honorable career for decades.
Health Care Fraud Should Not Be Taken Lightly.

We have been consulted by many individuals, both before and after criminal convictions for fraud or related offenses. In many cases, those subject to Medicare fraud audits and investigations refuse to acknowledge the seriousness of the matter. Some may even decide not to spend the money required for a highly experienced health attorney to defend them.

The government is serious about combating health care fraud. It created a Medicare Fraud Strike Force in March of 2007, in an effort to further prevent and eliminate fraud and abuse of government health care programs. False claims are a growing problem in the program, costing the government billions of dollars each year. Accordingly, punishments for defrauding the system can be quite severe.

If you are accused of Medicare fraud, realize that you are in a fight for your life. Your liberty, property/possessions and profession are all at stake. Often it is possible to settle allegations of Medicare fraud by agreeing to pay civil monetary penalties and fines. If given such an opportunity, the Medicare provider should consider whether it is worth the risk of facing decades in prison. Be prepared to give up whatever you need to in order to avoid a conviction and preserve your liberty.

To read further about the seriousness of Medicare fraud, click here to read one of my prior blogs.

Additionally, you can watch our informational video blog on Medicare fraud, here.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare Issues Now.

The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.
Sources:

Lane, Emily. “4 New Orleans doctors, 2 others convicted in $13.6 million Medicare fraud scheme.” The Times-Picayune. (May 10, 2017). Web.

“4 New Orleans doctors, 2 others convicted in $13.6 million Medicare fraud scheme.” Health Leaders Media. (May 11. 2017). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
Keywords: Legal representation for Medicare fraud, Medicare fraud defense attorney, legal representation for allegations of Medicare fraud, legal representation for health care fraud, legal representation for fraudulent billing, legal representation for allegations of defrauding the government, legal representation for submitting false claims, Medicare audit defense attorney, Medicare billing defense attorney, health care clinic fraud audit, legal representation for illegal kickbacks, Medicare false claims defense attorney, legal representation for false billing, legal representation for allegations of unnecessary procedures, legal representation for Medicare audits, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Health law defense attorney

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

It is Always a Bad Idea for a Doctor, Nurse or Health Professional to . . . .

3 Indest-2009-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

My experience in representing doctors, nurses and other licensed health professionals in disciplinary cases has lead me to conclude, us to conclude, its is always a bad idea for them to:

1. Write a prescription for any medication for yourself.

2. Start a romantic relationship with a patient.

3. Take someone else’s prescription medication, ever.

4. Write a prescription for or treat a patient, especially a family member, for a condition outside the scope of his specialty (e.g., a dentist prescribing antibiotics to her children to treat a cold; a pediatrician prescribing pain medications for an adult; a dentist writing a prescription for pain medications for a patient’s back paid; an OB/GYN prescribing antidepressants for a male).

5. Write any prescription for or treat any patient who is in another state when the physician is not licensed in that state.

6. Treat or prescribe for any spouse, other family member, friend or colleague, without opening a medical record and fully documenting the treatment or prescription, as you would for any other patient.

7. Hire a patient to work for you in your office or, especially, allow a patient to “volunteer” to work in your office.

8. Pre-sign blank prescriptions for your Physician Assistant, ARNP, Medical Assistant, receptionist, or anyone else, to complete later, or have pre-signed blank prescriptions in your office.

9. Seek psychotherapy or drug/alcohol abuse treatment with a physician or HCP health professional in your own medical group, institution or the staff of your own hospital.

10. Add to, alter or change any medical/dental record entry after you know there may be a claim, investigation or litigation involving it.

11. For a mental health professional (psychiatrist, psychologist, mental health counselor, social worker, psychiatric nurse practitioner) to have any type of social relationship with a current patient.

12. Take and use your own drug samples provided by pharmaceutical companies.

13. Go into a hospital where you do not have clinical privileges and treat or “assist” in treating a patient there, even if it is your own patient.

14. Have a sexual relationship ( including “sexting” or “telephone sex”) with a patient or patient’s immediate family member.

These are actual examples from cases in which I have had to represent licensed health professionals in defending their licenses and attempting to keep their jobs. For each of the above, there have been more than one.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys. We represent medical students, interns, residents, and fellows in disputes with their graduate medical education (GME) programs. We represent clinical professors and instructors in contract disputes, employment disputes, clinical privileges matters and other disputes with their employers. We often act as the physician’s personal counsel in medical malpractice litigation.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at http://www.TheHealthLawFirm.com

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.