DME Owner Convicted on all Counts
|April 2, 2014|
HOUSTON – Andrea Michelle Tellison, 47, has been convicted today of 14 counts of health care fraud and seven counts of aggravated identity theft, announced United States Attorney Kenneth Magidson. The jury returned its verdicts this afternoon following three days of trial and less than two hours of jury deliberation.
Tellison, the director of operations, chief compliance officer and co-owner of Texas Durable Medical Company was charged in March 2013 with health care fraud and aggravated identity theft in relation to the submission of approximately $1.48 million worth of enteral nutrition and enteral feeding supply claims to Medicare.
During trial, jurors heard the testimony of six Medicare beneficiaries detailing that they did not need tube feedings and did not receive tube feeding supplies despite Tellison billing thousands of dollars for those items. They also heard from seven Houston area physicians who stated they did not order tube feedings or tube feeding supplies for the Medicare beneficiaries and that they did not authorize Tellison to use their names and UPIN numbers to submit claims to Medicare and Medicaid for those items.
The government presented evidence including many forms that had been signed by Tellison indicating that Medicare beneficiaries needed tube feedings and tube feeding supplies. However, evidence demonstrated she did not order those items for delivery despite billing Medicare for the 29,113 tube feeding supply kits.
Special Agents from the Railroad Retirement Board (RRB) and the FBI testified that in a 2011 interview, Tellison admitted both knowledge of the false and fraudulent claims and the insufficient inventory for delivery to Medicare beneficiaries. A Forensic accountant from the FBI further testified that Tellison not only failed to purchase the 29,113 tube feeding supply kits, but that she also failed to purchase sufficient quantities of nutritional products for delivery. Various representatives from Medicare and Medicaid contractors provided supporting testimony about how these federally funded programs operate and the claims submitted by Tellison.
U.S. District Judge Lee Rosenthal, who presided over the trial, permitted Tellison to remain on pending sentencing to be held later this year. At that time, she faces up to 10 years in federal prison on each count of health care fraud and a mandatory two-year-term for each count of aggravated identity theft which must be served consecutively to each other and to any other prison term imposed.
The investigation into Tellison was the result of a joint investigation conducted by agents from the FBI, RRB - Office of the Inspector General, Department of Health and Human Services – Office of Inspector General and the Texas Attorney General’s Office Medicaid Fraud Control Unit. Assistant United States Attorneys Julie Redlinger and Tina Ansari prosecuted the case.