Dallas Attorney and Family Members in Federal Custody for Allegedly Committing Health Care Fraud, Theft of Government Funds and Mail Fraud

DALLAS — After his arrest today, Dallas attorney Tshombe Anderson remains in federal custody, along with his wife Brenda Anderson and his sister Lydia Bankhead, on charges outlined in a federal criminal complaint stemming from a scheme they ran to fraudulently obtain more than $22 million from the Department of Labor (DOL) Office of Worker’s Compensation Program (OWCP), announced U.S. Attorney John Parker of the Northern District of Texas.

Tshombe Anderson, 52, was arrested today, and his wife was arrested on Wednesday in Dallas.  Bankhead was also arrested on Wednesday in Russellville, Arkansas.  Brenda Anderson, 45, and Bankhead, 61, each made their initial appearance before a U.S. Magistrate Judge, and both are scheduled for detention hearings next week.  Tshombe Anderson will make his initial appearance in federal court on Monday, August 31, 2015, before U.S. Magistrate Judge Paul D. Stickney.

According to the complaint, unsealed today, Tshombe Anderson worked as an attorney for Union Treatment Center (Union), a treatment and rehab center with offices in Austin, Corpus Christi, Killeen and San Antonio, Texas, from approximately February 2010 to May 2011.  Union specialized in treating injured state and federal worker’s compensation patients.  In February 2010, Brenda Anderson also began working for Union, and shortly thereafter, she formed Best First Administration (BFA) Durable Medical Equipment (DME) of Austin, which became Union’s “in-house” DME provider.

In general, according to the complaint, a Union doctor would provide Brenda Anderson with a prescription for a patient’s DME items, and she would then send the prescribed DME to the patient.  BFA billed OWCP and deposited the payment for the DME into BFA’s designated bank account.

However, in May 2011, Union fired Tshombe and Brenda Anderson because an audit revealed they appeared to be engaging in fraudulent billing practices, according to the complaint.  The following month, Union created their own “in-house” DME company to provide patients with necessary treatment supplies.  Brenda Anderson and BFA, however, retained patient records and identifying information and used that information to continue to bill OWCP for unrequested and/or unnecessary DME sent to Union patients.

In January 2013, Tshombe Anderson formed Union Medical Supplies & Equipment, LLC (UMSE), which records indicate was managed by Lydia Bankhead and their mother.  In April 2013, USME began fraudulently billing OWCP for DME delivered to the same Union patients as BFA.  In January 2014, USME changed its address with OWCP from 327 Cedar Creek Drive in Duncanville, Texas, to 2606 Martin Luther King Jr. Blvd., in Dallas, an address located next door to The Law Office of Tshombe A. Anderson, LLC, located at 2604 Martin Luther King Jr. Blvd., in Dallas.  Every DME transaction billed by UMSE since its formation appears to be fraudulent.

In May 2013, Tshombe Anderson formed Sky-Care Medical Supplies & Equipment, LLC (SMSE).  Records list Tshombe Anderson’s sister-in-law as SMSE’s Manager.  In August 2013, SMSE began billing OWCP for the same patients as BFA and UMSE; every DME transaction billed by SMSE since its formation appears to be fraudulent.

In January 2014, Tshombe Anderson formed American Federal Union Claims Advocates, LLC (AFUCA).  Tshombe Anderson is listed as the only managing member of this company, and the company’s address is the same as that of his law office.

OWCP billing records from January 2011 through April 9, 2015, indicate that 292 patient claim numbers were filled by at least one of the Andersons’ three DME companies.

From April 11, 2013 through April 9, 2015, USME billed approximately $22,498,085 and was paid $19,573,704 by OWCP for DME that was not needed or requested by the patient or the doctor treating the patient.

From August 7, 2013 through April 9, 2015, SMSE billed approximately $1,833,895 and was paid $1,706,848 by OWCP for DME that was not needed or requested by the patient or the doctor treating the patient.

A federal complaint is a written statement of the essential facts of the offense charged, and must be made under oath before a magistrate judge.  A defendant is entitled to the presumption of innocence until proven guilty.  The U.S. Attorney’s office has 30 days to present the matter to a grand jury for indictment.  The maximum statutory penalty for both health care fraud and theft of government funds is 10 years in federal prison and a $250,000 fine.  The maximum statutory penalty for mail fraud is 20 years in federal prison and a $250,000 fine.

The DOL Office of Inspector General and the U.S. Postal Service Office of Inspector General are investigating.  Special Assistant U.S. Attorney Danial Gividen and Assistant U.S. Attorneys Aaron Wiley and Lea Carlisle are in charge of the prosecution.

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