NEW ORLEANS – U.S. Attorney Peter G. Strasser announced today the sentencing of four local physicians, a biller, and office manager following a four week trial that ended on May 9, 2017.
Specifically, HENRY EVANS, age 74, was found guilty of five counts of health care fraud; MICHAEL JONES, age 49; PAULA JONES, age 45; SHELTON BARNES, age 63; GREGORY MOLDEN, age 60, all of New Orleans; and JONATHON NORA, age 31, of River Ridge, were all found guilty of conspiracies to commit health care fraud and to receive and pay health care kickbacks, and health care fraud. BARNES, MICHAEL JONES, MOLDEN, and NORA were also found guilty of individual counts of health care fraud. Additionally, BARNES was found guilty of obstruction of a federal audit.
The Second Superseding Indictment rises out of an Indictment returned in March 2015 charging Abide owner, Lisa Crinel, and others with health care fraud. Nineteen individuals and/or companies pleaded guilty before trial to charges associated with the original Indictment.
According to the Second Superseding Indictment, the defendants fraudulently billed Medicare for medically unnecessary home health services for patients who were not homebound. BARNES, EVANS, MOLDEN, and MICHAEL JONES, known as “House Doctors,” ordered home health services for Medicare beneficiaries who had no legitimate medical necessity. The House Doctors falsely signed home health orders regardless of the beneficiaries’ needs, homebound status, or diagnoses. In return, BARNES, EVANS, and MOLDEN received illegal monthly payments characterized as medical consultant or director fees for which they provided no services other than fraudulently certifying Medicare beneficiaries for unnecessary home health services. Instead of receiving monthly payments from the home health agency, Abide hired PAULA JONES, MICHAEL JONES’ wife and, thereafter, inflated salary payments to PAULA JONES in order to pay MICHAEL JONES’ fees for fraudulently certifying ineligible Medicare beneficiaries.
Marketers contacted JONATHON NORA and others to confirm that the person fraudulently referred for home health was a Medicare beneficiary. Once NORA determined that the referred individual was a Medicare beneficiary, NORA scheduled a physician visit, usually with an Abide House Doctor, well knowing that the individual referral to Abide was by a Marketer, instead of the beneficiary’s own health care professional.
Abide generated plans of care reflecting the falsely created assessments. The plans of care were given to BARNES, EVANS, MOLDEN, and MICHAEL JONES to falsely certify and recertify medically unnecessary episodes of home health. PAULA JONES fraudulently billed Medicare, on behalf of Abide, for the medically unnecessary home health services.
U.S. District Judge Susie Morgan sentenced SHELTON BARNES, age 64, to sixty (60) months imprisonment, followed by one (1) year of supervised release, and restitution in the amount of $10,850,229 to be paid to Medicare.
Judge Morgan sentenced HENRY EVANS, age 74, to fifty (50) months imprisonment, followed by one (1) year of supervised release, and restitution in the amount of $1,262,043 to be paid to Medicare.
Judge Morgan sentenced GREGORY MOLDEN, age 62, to forty-eight (48) months imprisonment, followed by one (1) year of supervised release, and restitution in the amount of $626,405 to be paid to Medicare.
Judge Morgan sentenced MICHAEL JONES, age 49, to thirty-six (36) months imprisonment, followed by two (2) years of supervised release, and restitution in the amount of $347,525 to be paid to Medicare.
Judge Morgan sentenced PAULA JONES, age 45, to one year and one day imprisonment, followed by three (3) years of supervised release, and restitution in the amount of $3,106,954 to be paid to Medicare. Upon her release from imprisonment, PAULA JONES was ordered to serve a term of home detention for a period of 24 months.
Judge Morgan sentenced JONATHON NORA, age 31, to forty (40) months imprisonment, followed by one (1) year of supervised release, and restitution in the amount of $12,921,797 to be paid to Medicare.
U.S. Attorney Strasser praised the work of the Special Agents of the Federal Bureau of Investigation and the United States Department of Health and Human Services, Office of Inspector General in investigating this matter. Assistant U.S. Attorneys Patrice Harris Sullivan, Sharan Lieberman, Maria Carboni, and Andre Lagarde prosecuted the case.
* * *