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Thursday, September 25, 2014

Seven Defendants Indicted and Three Other Defendants Plead Guilty for Their Roles in $56 Million Medicare Fraud Scheme

A New Orleans grand jury today indicted seven defendants for their roles in a $56 million Medicare fraud scheme that operated in New Orleans and surrounding communities.  Thirteen defendants have now been charged in this case, three of whom pleaded guilty to their conduct yesterday. 

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

Paige Okpalobi, 57, of Slidell, Louisiana; Joe Ann Murthil, 57, of New Orleans; Latausha Dannel, 34, of Laplace, Louisiana; Dr. Winston Murray, 62, of Hammond, Louisiana; Dr. Divini Luccioni, 53, of Kenner, Louisiana; Christopher White, 48, of Destrehan, Louisiana; and Beverly Breaux, 66, of New Orleans, were charged in connection with their roles in a home health care fraud scheme involving thousands of Medicare recipients.  Mark Morad, 51, of Slidell; Dr. Barbara Smith, 65, of Metairie, Louisiana; and Dr. Roy Berkowitz, 68, of Slidell, had been previously charged for their participation in the scheme, and today’s indictment added new charges against them.

The second superseding indictment comes one day after Dr. Alvin Darby, 58, of Slidell; Demetrius Temple, 54, of New Orleans; and Nicole Oliver, 44, of Napoleonville, Louisiana, each pleaded guilty to conspiracy to commit health care fraud for their roles in the scheme.  Sentencing for each is scheduled for Jan. 7, 2015 before U.S. District Judge Sarah S. Vance of the Eastern District of Louisiana.

The indictment alleges that the defendants operated a number of companies in and around New Orleans that purported to offer home health services and durable medical equipment to Medicare beneficiaries.  The companies, Interlink Health Care Services Inc., Memorial Home Health Inc., Lakeland Health Care Services Inc., Lexmark Health Care LLC, Med Rite Pharmacy Inc. and Medical Specialists of New Orleans, billed Medicare claiming that they provided home health services and durable medical equipment to Medicare beneficiaries, but the vast majority of these services and equipment were not medically necessary or not provided. 

The indictment further alleges that Morad and Okpalobi owned and directed operations at these companies.  Morad allegedly paid kickbacks to patient recruiters, including Temple and Oliver, to provide Medicare beneficiary numbers that were then used to bill Medicare.  To conceal these kickbacks, Morad allegedly laundered Medicare money through a separate company he owned. 

Court documents also allege that Okpalobi instructed doctors, including Smith, Berkowitz, Murray, Luccioni, and Darby, to falsely certify that beneficiaries were qualified for home health services, and to prescribe durable medical equipment that was not medically needed.  These false certifications and prescriptions were then used to bill Medicare for the unnecessary services and equipment. 

Murthil and Dannel were office managers who allegedly oversaw daily operations at the home health companies.  White allegedly performed accounting services for these companies, and helped conceal the scheme by fabricating false tax and employee records.  Breaux was a registered nurse who is alleged to have falsely certified that home health clients were homebound, and that she had provided home health care services when she had not.

From 2007 through 2014, the companies allegedly involved in the scheme submitted more than $56 million in claims to Medicare, the majority of which are allegedly fraudulent.  Medicare paid approximately $50.7 million on those claims.

The charges contained in this indictment are merely accusations, and the defendants are innocent unless and until proven guilty.

The case is being investigated by HHS-OIG and the FBI 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.  The case is being prosecuted by Trial Attorney William G. Kanellis of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Patrice Harris Sullivan of the Eastern District of Louisiana.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion.  In addition, the HHS 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 Team (HEAT), go to: www.stopmedicarefraud.gov.

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Updated January 8, 2016