Houston Patient Recruiter Convicted in $1.1 Million Medicare Fraud Scheme
To Date, Five Individuals Guilty of Federal Crimes for Roles in Scheme
WASHINGTON – A patient recruiter for a Houston durable medical equipment (DME) company was convicted today by a federal jury in Houston of health care fraud related to an “arthritis kit” fraud scheme, the Department of Justice, FBI and Department of Health and Human Services (HHS) announced.
After a four-day trial, Michelle Turner, 44, of Spring, Texas, was convicted of one count of conspiracy to commit health care fraud, one count of conspiring to receive illegal kickbacks for referring Medicare beneficiaries and two counts of receiving illegal kickbacks for referring Medicare beneficiaries.
According to evidence presented at trial, Clifford Ubani and Princewill Njoku were the owners of Family Healthcare Services. Family Healthcare maintained a valid Medicare provider number in order to submit Medicare claims for the costs of DME and purported to provide orthotics and other DME to Medicare beneficiaries. Ubani and Njoku hired co-conspirators Turner, Ana Quinteros and others to recruit beneficiaries for the purposes of filing claims with Medicare for DME. Once Ubani and Njoku obtained Medicare beneficiary numbers, Family Healthcare submitted claims to Medicare for DME, including orthotic devices, which were medically unnecessary and/or not provided. Co-conspirator Rolondae Mitchell-Straughter was the office manager and was responsible for processing the fraudulent claims. Many of the orthotic devices were components of what was referred to as an “arthritis kit” and were purported to be for the treatment of arthritis-related conditions, but the devices were not medically necessary or appropriate for such conditions. The arthritis kit generally contained a number of orthotic devices, including braces for both sides of the body and related accessories, such as heat pads. Ubani and Njoku paid kickbacks to the recruiters for their referrals. In total, Family Healthcare submitted approximately $1.1 million in fraudulent claims to Medicare.
Evidence at trial showed that Turner operated a “boiler room” and hired teenagers to make unsolicited telephone calls to elderly Medicare beneficiaries asking them if they wanted a free arthritis kit. The arthritis kit was billed to Medicare at more than $3,000. Under Medicare rules, unsolicited telephone calls are prohibited. Additionally, a Medicare beneficiary is responsible for paying a 20 percent co-pay for all DME. Beneficiaries’ doctors further testified at trial that the beneficiaries did not need the arthritis kit.
Ubani and Njoku previously pleaded guilty to conspiracy to commit health care fraud and await sentencing. Mitchell-Straughter pleaded guilty to conspiracy to commit health care fraud and was sentenced to 18 months in prison. Quinteros previously pleaded guilty to conspiracy to commit health care fraud and was sentenced to probation. A sixth defendant, Mary Ellis, was acquitted in this case by a jury in December 2010, but was later convicted of conspiracy to commit health care fraud in May 2011 in a separate case and was sentenced to 63 months in prison.
At sentencing, Turner faces maximum penalties of 10 years in prison for the health care fraud conspiracy count; five years in prison for conspiring to receive illegal kickbacks for referring Medicare beneficiaries; and five years in prison for each count of receiving an illegal kickback for referring a Medicare beneficiary.
Today’s guilty verdict was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Ken Magidson of the Southern District of Texas; Special Agent in Charge Stephen L. Morris of the FBI’s Houston Field Office; Special Agent in Charge Mike Fields of the Dallas Regional Office of the HHS Office of the Inspector General (HHS-OIG), Office of Investigations; and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU).
The case was prosecuted by Trial Attorney Charles D. Reed and Deputy Chief Sam S. Sheldon of the Criminal Division’s Fraud Section. The case was investigated by the FBI, HHS-OIG, Texas OAG-MFCU and the Federal Railroad Retirement Board-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section.
Since their inception in March 2007, Strike Force operations in nine locations have obtained indictments of 1,190 individuals who collectively have falsely billed the Medicare program for more than $3.2 billion. In addition, HHS’s 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 .