After a Six-Day Trial, Federal Jury Convicts Holy Health Care Services, LLC Program Administrator for a Health Care Fraud Scheme
Baltimore, Maryland – A federal grand jury has indicted Harry Crawford, age 55, Elma Myles, age 51, and Matthew Hightower, age 33, all of Baltimore, Maryland, on charges related to a scheme to defraud Medicaid and other health care benefit programs out of at least $900,000. The indictment was returned on June 3, 2015 and unsealed on June 17, 2015, upon the arrest of the defendants. These charges are part of a nationwide takedown by Medicare Fraud Strike Force operations in 17 cities, including Baltimore.
The indictment was announced by United States Attorney for the District of Maryland Rod J. Rosenstein; Special Agent in Charge Nicholas DiGiulio, Office of Investigations, Office of Inspector General of the Department of Health and Human Services; and Chief James W. Johnson of the Baltimore County Police Department.
According to the three-count indictment, Crawford owned and operated RX Resources and Solutions (RXRS), a durable medical equipment provider located in Randallstown, Maryland. RXRS provided hospital beds, wheelchairs, and disposable medical supplies including adult incontinence products, diabetic test strips and wound care items. Crawford was President and CEO of RXRS. Myles worked at the company and was responsible, among other things, for billing health care benefit programs for supplies provided by RXRS. Beginning in 2012, Hightower worked as a delivery driver for RXRS.
The indictment alleges that from 2010 through May 2014, Crawford and Myles conspired to defraud Medicaid and other health benefit programs by billing for supplies that were never provided, or overcharging for materials actually delivered, and by billing for supplies that were unneeded and had not been prescribed by a physician. The indictment alleges that Hightower joined the conspiracy in May 2012.
Specifically, the indictment alleges that the defendants used the personal identity information of clients to submit fraudulent claims to Medicaid and other health care benefits programs for disposable medical supplies that were not delivered to the beneficiary. In addition, the defendants allegedly delivered medical supplies to beneficiaries who did not need the supplies and whose physicians had not prescribed the supplies, even after the beneficiaries reported that they did not want or need the supplies. The indictment alleges that Hightower would sign or have someone else sign delivery tickets when deliveries had not actually taken place so that the records of RXRS would falsely document the delivery. According to the indictment, Hightower provided the forged and fraudulent delivery tickets to RXRS as part of his duties.
The indictment seeks the forfeiture of $900,000, as the proceeds of the offense.
The defendants face a maximum sentence of 10 years in prison for the conspiracy and for health care fraud; and a mandatory two years in prison, consecutive to any other sentence imposed, for aggravated identity theft. An initial appearance was held for all the defendants on June 17, 2015 in U.S. District Court in Baltimore. The defendants were released under the supervision of U.S. Pretrial Services.
An indictment is not a finding of guilt. An individual charged by indictment is presumed innocent unless and until proven guilty at some later criminal proceedings.
The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since their inception in March 2007, Strike Force operations in nine locations have charged over 2,300 defendants who collectively have falsely billed the Medicare program for over $7 billion.
Today’s enforcement actions resulted in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, as well as the three defendants charged in Maryland, for their alleged participation in Medicare and Medicaid fraud schemes involving approximately $712 million in false billings.
United States Attorney Rod J. Rosenstein praised the HHS-OIG and Baltimore County Police Department for their work in the investigation and thanked the Internal Revenue Service - Criminal Investigation, Washington, D.C. Field Office and the Maryland Medicaid Fraud Control Unit for their assistance. Mr. Rosenstein thanked Assistant United States Attorneys Sandra Wilkinson and Aaron Zelinsky, who are prosecuting the case.