Physician and Two Clinic Operators Found Guilty for Their Roles in $17 Million Medicare Fraud Scheme
A federal jury found a physician and two clinic owners and operators guilty yesterday for their roles in a $17 million Medicare fraud scheme.
Assistant Attorney General Brian A. Benczowski of the Justice Department’s Criminal Division, U.S. Attorney Ryan Patrick of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Region and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.
John P. Ramirez (Ramirez), M.D., 64; Ann Nwoko Shepherd (Shepherd), 62; and Yvette Nwoko (Nwoko), 30, all of Houston, Texas, were convicted of one count of conspiracy to commit health care fraud after a six-day trial. In addition, Nwoko was convicted of three counts of health care fraud, Shepherd was convicted of six counts of health care fraud and Ramirez was convicted of three counts of false statements relating to health care matters. Sentencing is scheduled for Dec. 12 before U.S. District Judge David Hittner of the Southern District of Texas, who presided over the trial.
According to evidence presented at trial, from approximately December 2011 to August 2015, Ramirez, Shepherd and Nwoko conspired and schemed to defraud Medicare out of payments for medical services. Shepherd owned and operated Southwest Total Medical Inc., a purported medical clinic doing business as Amex Medical Clinic in Houston. Shepherd sold medical orders and other documents signed by Ramirez to home-health agencies in and around Houston. Ramirez falsely certified in these medical orders information about the patient’s medical condition and need for medical services. Co-conspirators at home-health agencies then used the false and fraudulent paperwork signed by Ramirez and sold by Shepherd to bill and receive payment from Medicare for medical services that were not medically necessary or not provided. Later in the conspiracy and scheme, Nwoko acted as the manager of Amex Medical Clinic where she too sold false and fraudulent paperwork used by co-conspirators to bill and receive payment from Medicare for similarly unnecessary medical services, the evidence showed. Shepherd also caused Amex Medical Clinic to bill Medicare for purported physician services that were actually provided by an unlicensed practitioner, if at all, the evidence showed.
In all, Ramirez, Shepherd and Nwoko caused Medicare to pay approximately $17 million on false and fraudulent claims submitted during the charged conspiracy, the evidence showed.
This case was investigated by the FBI, HHS-OIG and the Texas Attorney General’s Medicaid Fraud Control Unit. Trial Attorney Scott Armstrong of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Tina Ansari of the Southern District of Texas are prosecuting the case.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in 12 cities across the country, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 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.