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Friday, March 18, 2016

New Orleans Jury Convicts Company Owner and Doctor for Roles in $34 Million Fraud Scheme

A federal jury in New Orleans convicted the owner of a health care company and a doctor for their roles in a $34 million Medicare fraud scheme that operated over the course of seven years in New Orleans and surrounding communities.   

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 and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Dallas Regional Office made the announcement.

Elaine Davis, 59, and Dr. Pramela Ganji, 66, both of New Orleans, were each convicted of one count of conspiracy to commit health care fraud and one count of health care fraud late yesterday after an eight-day trial before Chief U.S. Judge Kurt D. Englehardt of the Eastern District of Louisiana.  Davis and Ganji will be sentenced on July 6, 2016.

Evidence introduced at trial showed that Davis owned and controlled the operations of Christian Home Health Care Inc., and Davis and Ganji caused Christian to bill Medicare for home health care services that were not needed and/or were not provided.  In her role, Davis paid employees to recruit new patients from communities in and around New Orleans and Hammond, Louisiana.  Christian then sent the new patients’ Medicare information to doctors, including Ganji, to obtain their signatures to certify that the patients qualified to receive home health care services, which trial evidence showed they did not qualify for or need.  Trial evidence showed that Ganji had often never seen these patients and these false certifications allowed Davis and Christian to bill Medicare for home health services and to conceal that the services were unnecessary.  Evidence introduced at trial showed that from 2007 through June 2015, Christian submitted more than $34.4 million in claims to Medicare, a large number of which were fraudulent.  Medicare paid Christian approximately $29.6 million on these claims.

Davis was found not guilty of three additional counts of health care fraud and Ganji was found not guilty of one additional count of health care fraud.  Dr. Godwin Ogbuokiri was acquitted of all charges. 

The FBI and HHS-OIG investigated the case, which 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, Antonio Pozos and Drew Bradylyons of the Criminal Division’s Fraud Section prosecuted the 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, the HHS 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

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Topic: 
Healthcare Fraud
StopFraud
Updated August 10, 2016