WASHINGTON – A patient recruiter for Alliance Healthcare Services L.P., a Dallas home health care agency, pleaded guilty yesterday for her participation in a scheme to defraud Medicare and Medicaid, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS). Four co-owners of Alliance pleaded guilty last week for their roles in the fraud scheme.
Ollie Futrell, 56, of Garland, Texas, pleaded guilty yesterday before U.S. District Judge Jane J. Boyle in the Northern District of Texas to one count of conspiracy to commit health care fraud. Ernest Amadi and his wife, Edith Amadi, both of Wylie, Texas, pleaded guilty to the same charge on Dec. 6, 2011. George Opurum and his wife, Agatha Opurum, both of Richardson, Texas, also pleaded guilty to conspiracy to commit health care fraud on Dec. 8, 2011. The five defendants were indicted and arrested in February 2011. This case was the first case to be prosecuted by the Medicare Fraud Strike Force in Dallas.
According to court documents, Ernest Amadi, 53, was the chief executive officer and administrator of Alliance, and George Opurum, 60, was the chief financial officer and alternate administrator of Alliance. Edith Amadi, 49, and Agatha Opurum, 53, were both nurses at Alliance.
As part of the conspiracy, from November 2008 through mid-February 2011, Alliance submitted claims to Medicare for home health services purportedly provided to Medicare beneficiaries. According to court documents, Alliance employees, including the owners, falsified Medicare documentation and skilled nursing notes indicating that the patients were homebound and eligible for home health care services. In fact, the majority of Alliance patients were not eligible for the services because they were not homebound. According to court documents, Alliance employees and owners falsified time sheets and patient visit logs for services that were not adequately rendered or were never provided at all. Alliance then billed Medicare as if the services were adequately provided.
According to court documents, Alliance owners conspired with Futrell to recruit Medicare patients for the company so Alliance could increase its Medicare billing and revenue. Futrell was paid cash by Alliance owners. She agreed to pay patients kickbacks so that they would continue to use Alliance. Often, Futrell paid patients $100 per month to continue to receive home health care from Alliance. Alliance owners knew about, and at times facilitated, these kickbacks.
Each defendant faces a maximum sentence of 10 years in prison, a $250,000 fine and restitution. Ernest and Edith Amadi are scheduled to be sentenced on April 19, 2012. George and Agatha Opurum are scheduled to be sentenced on April 5, 2012. Ollie Futrell is scheduled to be sentenced on April 26, 2012. All sentencings will be before Judge Boyle.
The guilty pleas were announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Sarah R. Saldaña of the Northern District of Texas; Special Agent in Charge Robert E. Casey Jr. of the FBI’s Dallas Field Office; Special Agent in Charge Mike Fields of the Dallas Regional Office of HHS’s Office of the Inspector General (HHS-OIG); and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU).
The case is being prosecuted by Assistant U.S. Attorney Katherine E. Pfeifle of the Northern District of Texas and Trial Attorney Benjamin A. O’Neil of the Fraud Section in the Justice Department’s Criminal Division. The case was investigated by the FBI, HHS-OIG and the Texas Attorney General’s MFCU.
Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,140 defendants who collectively have falsely billed the Medicare program for more than $2.9 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.