Baton Rouge Woman Sentenced To Lengthy Prison Term For Her Role In Multi-million Dollar Medicare Fraud Scheme

BATON ROUGE, LA – An owner and operator of community mental health centers in Baton Rouge, Louisiana, and Houston, Texas, was sentenced today to serve more than eight years in prison for her role in an extensive Medicare fraud scheme. Chief U.S. District Court Judge Brian A. Jackson sentenced HOOR NAZ JAFRI, age 54, of Baton Rouge, Louisiana, to one hundred and two (102) months in federal prison, to be followed by a three-year term of supervised release. JAFRI was also ordered to pay restitution in the amount of $43,528,584 and will be required to forfeit all proceeds from the fraudulent scheme.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney for the Middle District of Louisiana Walt Green, Special Agent in Charge Mike Fields of the Dallas Region of the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), Special Agent in Charge Michael Anderson of the FBI’s New Orleans Division, and Louisiana State Attorney General Buddy Caldwell made the announcement. JAFRI had previously pled guilty to Count One of a Superseding Indictment, charging her with conspiracy to commit health care fraud, in violation of Title 18, United States Code, Section 1349, and Count Eleven, charging her with conspiracy to pay and receive health care kickbacks, in violation of Title 18, United States Code, Section 371.

According to documents filed in the case, the investigation into three community mental health centers - Shifa Community Mental Health Center of Baton Rouge, Serenity Center of Baton Rouge, and Shifa Community Mental Health Center of Texas - was opened in 2011, and since then has resulted in the convictions of seventeen (17) individuals employed by the facilities, including therapists, marketers, administrators, owners and the medical director. Over a period of approximately seven years, the companies billed Medicare for partial hospitalization program services for the mentally ill that were unnecessary or never provided. The companies, collectively, submitted more than $258 million in claims to Medicare during this period. Medicare paid approximately $43.5 million on those claims.

JAFRI was an owner of all three facilities and a marketer for Shifa and Serenity in Baton Rouge. JAFRI was also part owner of two affiliated residential facilities; patients who lived at these apartments were required to attend the programs at Shifa and Serenity, regardless of whether these patients actually needed or desired the services. As a marketer for Shifa and Serenity, JAFRI caused patients to be admitted to the facilities who were inappropriate for the services. JAFRI directed administrators and therapists at these facilities to falsify records for treatment that patients did not in fact receive. JAFRI also authorized $1,500 per week to be paid in cash to a recruiter in Houston, Texas so that the recruiter would direct patients to attend the partial hospitalization program at Shifa Texas. The recruiter, in turn, paid each patient $75 per week to attend the program.

The case is being investigated by HHS-OIG, the FBI, and the Medicaid Fraud Control Unit of the Louisiana Attorney General’s Office, 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 Middle District of Louisiana. The case is being prosecuted by Trial Attorneys Abigail Taylor and Dustin M. Davis of the Criminal Division’s Fraud Section and Assistant United States Attorney Shubhra Shivpuri of the U.S. Attorney’s Office for the Middle District of Louisiana.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 1,900 defendants who have collectively billed the Medicare program for more than $6 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 Team (HEAT), go to: www.stopmedicarefraud.gov.