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Wednesday, December 16, 2015

New Orleans Doctors and Registered Nurse Sentenced for Roles in $50 Million Fraud Scheme

Two doctors and a registered nurse were sentenced to prison today for their roles at the center of a $50 million health care fraud scheme in New Orleans.

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 Jeffrey S. Sallet of the FBI’s New Orleans Field Office, Special Agent in Charge CJ Porter of the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) Dallas Regional Office and the Louisiana Attorney General’s Medicaid Fraud Control Unit made the announcement.

Dr. Barbara Smith, 67, of Metairie, Louisiana; Dr. Roy Berkowitz, 69, of Slidell, Louisiana; and Beverley Breaux, 67, of New Orleans, a registered nurse, were sentenced by U.S. District Judge Sarah S. Vance of the Eastern District of Louisiana to 80 months, 64 months and 50 months in prison, respectively.  Judge Vance also ordered Smith, Berkowitz and Breaux to pay $9,484,939, $4,952,816 and $2,057,179 in restitution, respectively. 

Evidence introduced at trial showed that the defendants and others carried out a home health care fraud scheme in and around New Orleans through multiple companies over the course of more than 10 years.  Smith and Berkowitz falsely certified that thousands of Medicare recipients were homebound and required nursing or therapy services to be provided in their homes.  Breaux falsely certified that these patients were homebound and falsely claimed to have treated patients that she had not seen.  From 2007 through 2014, the companies in this scheme submitted more than $56 million in claims to Medicare, the 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 of the Eastern District of Louisiana.  Trial Attorneys William Kanellis and Antonio Pozos of the Fraud Section prosecuted this case.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,300 defendants who have collectively billed the Medicare program for more than $7 billion.  In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is 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

Healthcare Fraud
Updated January 8, 2016