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Thursday, April 23, 2015

Louisiana Doctor Pleads Guilty to Health Care Fraud Charges for Writing False Home Health Certifications in $56 Million Fraud Scheme

A Louisiana doctor pleaded guilty to federal health care fraud charges today, admitting that he wrote false home health care certifications that were used in a multi-million dollar Medicare fraud scheme.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Kenneth A. Polite of the Eastern District of Louisiana, Special Agent in Charge Michael Anderson of the FBI’s New Orleans Field Office, Special Agent in Charge Mike Fields of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Regional Office and Louisiana Attorney General James D. “Buddy” Caldwell made the announcement.

Winston Murray, M.D., 62, of Hammond, Louisiana, pleaded guilty before Chief U.S. District Judge Sarah S. Vance of the Eastern District of Louisiana to all three charges against him, including one count of conspiracy to commit health care fraud and two counts of health care fraud.  He is scheduled to be sentenced on Aug. 12, 2015.  Murray is the ninth defendant to plead guilty in this case.  The trial for the remaining four defendants is scheduled to begin on May 6, 2015.

At his plea hearing, Murray admitted that he operated a clinic in Hammond, Louisiana, from which he wrote home health care referrals for Medicare beneficiaries he knew were not confined to their homes.  Murray further admitted that his referrals were used by home health companies Interlink Health Care Services Inc. (Interlink) and Lakeland Health Care Services Inc. (Lakeland), among others, to fraudulently bill Medicare for home health services supposedly rendered to hundreds of Medicare beneficiaries living in and around Hammond and New Orleans.

Medicare records reveal that Murray’s certifications were used by Interlink and Lakeland to bill Medicare for more than $2.2 million in home health services that were not medically needed or were not provided.  From 2007 through 2014, these companies and other companies involved in this scheme submitted more than $56 million in claims to Medicare, a vast majority of which were fraudulent.  Medicare paid approximately $50.7 million on these claims.

This case was investigated by the FBI, HHS-OIG and the Louisiana Attorney General’s Medicaid Fraud Control Unit, 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 Eastern District of Louisiana.  This case was prosecuted by Trial Attorneys William Kanellis and Antonio Pozos and Assistant Chief Ben Curtis of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5 billion.  In addition, the HHS Centers for Medicare & 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.

Healthcare Fraud
Updated April 23, 2015