Former Louisiana Health Clinic CEO Sentenced to 82 Months in Federal Prison for Medicaid Fraud Scheme
WASHINGTON - Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Alex M. Azar III, announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 601 charged defendants across 58 federal districts, including 165 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $2 billion in false billings. Of those charged, more than 162 defendants, including 76 doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty (30) state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS announced today that from July 2017 to the present, it has excluded 2,700 individuals from participation in Medicare, Medicaid, and all other Federal health care programs, which includes 587 providers excluded for conduct related to opioid diversion and abuse.
Attorney General Sessions and Secretary Azar were joined in the announcement by Acting Assistant Attorney John P. Cronan of the Justice Department’s Criminal Division, Deputy Director David L. Bowdich of the FBI, Assistant Administrator John Martin of the Drug Enforcement Administration (DEA), Inspector General Daniel R. Levinson of the HHS Office of Inspector General (OIG), Deputy Chief Eric Hylton of IRS Criminal Investigation, Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS), and Director Dermot F. O’Reilly of the Defense Criminal Investigative Service (DCIS).
As part of the National Health Care Fraud and Opioid Takedown, in Baton Rouge, Louisiana, United States Attorney Brandon J. Fremin announced new charges against 26 individuals for health care fraud, opioid-related crimes, and related offenses. The Medicare Fraud Strike Force is part of the joint initiative announced in May 2009 between the U.S. Department of Justice and the U.S. Department of Health and Human Services to reduce and prevent Medicare and Medicaid fraud through enhanced cooperation. In December 2009, a Medicare Fraud Strike Force team was deployed in the U.S. Attorney’s Office in Baton Rouge, Louisiana. Over the past eight years, the team has continued working in Baton Rouge and expanded across southern Louisiana.
Christopher Armstrong / Louisiana Spine & Sports
In the first case, a federal grand jury has returned an indictment charging Christopher William ARMSTRONG, age 43, of Prairieville, Louisiana, with health care fraud, conspiracy to violate the federal Controlled Substances Act, and possession with intent to distribute a controlled substance. According to the indictment, ARMSTRONG was a licensed physician’s assistant and was employed by Louisiana Spine & Sports LLC, a pain management clinic in Baton Rouge from approximately August 2004 through approximately January 2014. In that role, ARMSTRONG allegedly logged into the clinic’s electronic computer system and, without authorization, created fraudulent prescriptions for controlled substances such as oxycodone and hydrocodone and then either forged the signatures of the clinic’s physicians on the prescriptions or surreptitiously caused physicians to unwittingly sign the prescriptions.
According to the indictment, ARMSTRONG would provide the fraudulent prescriptions to other individuals, who would fill the prescriptions and return the controlled substances to ARMSTRONG. At this point, according to the indictment, in an effort to conceal the scheme, ARMSTRONG would delete the records of the fraudulent prescriptions from the clinic’s computer system. Through this alleged scheme, the indictment alleges that the defendant caused local pharmacies to submit false and fraudulent claims to TRICARE, a federal health benefit program; that the defendant conspired with others to obtain controlled substances such as oxycodone and hydrocodone by misrepresentation and fraud, and to possess the substances with the intent to distribute them; and that, on various dates in 2013, the defendant actually possessed such substances with intent to distribute them.
This ongoing investigation is being handled by the Drug Enforcement Administration, the U.S. Department of Health and Human Services—Office of Inspector General (HHS-OIG), and the Federal Bureau of Investigation. The investigation was further developed by the East Baton Rouge District Attorney’s Office. The prosecution is being led by Christopher B. Brinson, a Trial Attorney with the Department of Justice’s Criminal Division—Fraud Section, Assistant U.S. Attorney Demetrius D. Sumner, and Dustin Davis, Assistant Chief of the Fraud Section.
Gretchen Duplantis / Spine & Body
In the second case, the court has unsealed a bill of information charging Gretchen DUPLANTIS, age 44, of Prairieville, Louisiana, with two counts of health care fraud. According to the bill and related documents that the defendant has signed, DUPLANTIS was the owner, operator, and managing employee of Spine and Body, LLC (“Spine and Body”), a physical therapy clinic located in Baton Rouge. Beginning in March of 2012 and continuing through March of 2014, DUPLANTIS, through Spine and Body, submitted fraudulent claims to Medicare and Blue Cross Blue Shield of Louisiana (BCBSLA) for physical therapy treatments she had purportedly provided to individuals at her clinic. Specifically, DUPLANTIS allegedly (1) billed Medicare and BCBSLA for therapy sessions when the patients had not received any treatment; (2) billed BCBSLA for therapy sessions purportedly performed on Spine and Body employees, who had not received any such treatment; and (3) billed for treatments that had been provided by unlicensed employees, contrary to representations made to BCBSLA and Medicare in the claims. From March of 2012 through March of 2014, DUPLANTIS, through Spine and Body, submitted approximately $1.6 million in claims to Medicaid and BCBSLA and was paid more than $470,000. The ongoing investigation is being handled by HHS-OIG and the FBI and the prosecution is being led by Dustin Davis, who serves as Assistant Chief of the Department of Justice’s Criminal Division—Fraud Section, and Assistant U.S. Attorney Demetrius D. Sumner.
Mark Stephan Immasche
In the third case, the United States has filed a bill of information charging Mark Stephan IMMASCHE, age 44, of Prairieville, Louisiana, with conspiracy to possess with the intent to distribute oxycodone. According to the bill of information, beginning in approximately 2012 and continuing through April 2017, IMMASCHE conspired with others to possess with the intent to distribute oxycodone, a Schedule II controlled substance. The ongoing investigation is being handled by HHS-OIG and the FBI and the prosecution is being led by DOJ Trial Attorney Christopher B. Brinson and AUSA Demetrius D. Sumner.
In the fourth case, a federal grand jury has returned an indictment charging Michael Dan GAINES, age 65, of Baker, Louisiana, with three counts of health care fraud. GAINES was a supervisory-level licensed clinical social worker at St. Gabriel Health Clinic, Inc. (St. Gabriel), a federally qualified health center in St. Gabriel, Louisiana, which contracted with the Iberville Parish School Board to provide medical services within the school district. FQHCs such as St. Gabriel could also provide services related to the diagnosis and treatment of mental illnesses, or Axis I disorders, provided that any such treatment was medically necessary, among other requirements. According to the indictment, however, St. Gabriel would provide character development seminars and other educational, character-building programs to entire classrooms of students during regular class periods, and then submit claims to Medicaid as though St. Gabriel had performed group psychotherapy, which St. Gabriel represented was medically necessary to treat the students’ purported actual Axis I disorders. According to the indictment, GAINES and others caused St. Gabriel practitioners to falsely record that students who attended the seminars had been diagnosed with Axis I disorders, and then, after each classroom visit, GAINES and others would create, complete, and certify progress notes that reiterated the previously diagnosed Axis I disorder and described the nature of the services that GAINES and others had purportedly provided as part of St. Gabriel’s treatment. According to the indictment, during the relevant time period, St. Gabriel’s claims for group psychotheraphy totaled more than $1.8 million. The indictment charges GAINES with causing the submission of numerous false claims to Medicaid for purported group psychotherapy in connection with the alleged scheme.
The case is being investigated by HHS-OIG, the Louisiana Attorney General’s Medicaid Fraud Control Unit, and the FBI. The case is being prosecuted by DOJ Trial Attorney Jared Hasten and Assistant U.S. Attorneys Jessica M.P. Thornhill and M. Patricia Jones.
In another case, a federal grand jury has returned an indictment charging Randy Lamartiniere, age 59, a physician in Baton Rouge, Louisiana, with 55 counts of distribution of controlled substances (opioids and Adderall). Nine of the counts involve Lamartiniere allegedly dispensing prescriptions after his license to practice medicine was suspended by the Louisiana State Board of Medical Examiners, with the suspension including a prohibition on prescribing controlled substances. The remaining forty-six counts involve Lamartiniere dispensing prescriptions for Adderall and opioids outside the scope of his medical practice and not for a legitimate medical purpose. According to the indictment, Lamartiniere’s unlawful prescriptions subjected at least 25 patients to serious injury and addiction. The case is being investigated by the DEA—Baton Rouge District Office’s Tactical Diversion Squad, the Iberville Parish Sheriff’s Office, the West Baton Rouge Sheriff’s Office, the Baton Rouge Police Department, the East Baton Rouge Parish Sheriff’s Office, and the Louisiana State Police. The prosecution is being led by AUSA Paul Pugliese.
Hot Off The Press
In the final case, the United States Attorney announced the unsealing of an indictment in Operation Hot Off The Press, an extensive, multi-year investigation that targeted an illegal drug trafficking network in the Baton Rouge area. The indictment names a total of twenty-one (21) defendants—Byron ROBBINS, Shanard Zelron BANKS, Reuben Maurice CRAWFORD, Toddriquez Deangelo BRADLEY, Chris D. DAVIS, Michael Wayne BROWN, Jr., Le’Alan Dequan BANKS, Ricky Elvis JOSEPH, Rodrick Demond HARRIS, Charlene Latrice BROCK, Darlene Patrice BROCK, Latasha Nicole BROCK, Nakia Martell BROCK, Stanley Renard LIAS, Jr., Kentrell Dontay AUGUSTUS, Zion HURST, Tremayne DABNEY, Daryl Joseph ADAMS, Jonathan Latard BOOTH, Clinton Keith CHAFFOLD, Jr., and Marjoe SANCHEZ HOLMES—all of whom are alleged to be residents of Baton Rouge, Zachary, Baker, and River Ridge, Louisiana.
The sixty-eight (68) count indictment charges the defendants with a wide variety of offenses, such as conspiracy; distribution of heroin, furanyl fentanyl, methamphetamine, and clonazolam; distribution of counterfeit substances; possession of punches and dies for counterfeiting controlled substances; and several additional controlled substance offenses. The indictment also charges several defendants with possession of firearms by convicted felons, possessing firearms in furtherance of drug-trafficking crimes, engaging in unlawful monetary transactions, and failure to file IRS Form 8300s. The ongoing investigation is being led by Assistant U.S. Attorney Cam T. Le.
The extensive investigation was led by the DEA, working in partnership with the U.S. Bureau of Alcohol, Tobacco, Firearms & Explosives, the Internal Revenue Service—Criminal Investigations Division, the Baton Rouge Police Department, the East Baton Rouge Parish Sheriff’s Office, and the Louisiana State Police, with valuable assistance from the Los Angeles County Sheriff’s Office. This operation was conducted as part of the Organized Crime Drug Enforcement Task Force (OCDETF) Program, which was established in 1982 to mount a comprehensive attack against organized drug traffickers. Today, the OCDETF Program is the centerpiece of the United States Attorney General’s drug strategy to reduce the availability of drugs by disrupting and dismantling major drug trafficking organizations and money laundering organizations and related criminal enterprises. The OCDETF Program operates nationwide and combines the resources and unique expertise of numerous federal, state, and local agencies in a coordinated attack against major drug trafficking and money laundering organizations.
The Medicare Fraud Strike Force operations are part of a joint initiative 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. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged more than 3,700 defendants who collectively have falsely billed the Medicare program for over $14 billion. In Baton Rouge, since 2009, the Baton Rouge-based Medicare Fraud Strike Force has charged more than 90 defendants with health care fraud and related offenses, achieving a 95% conviction rate.
U.S. Attorney Brandon Fremin stated: “Today’s historic announcement illustrates the top to bottom commitment by those in the U.S. Department of Justice to fight healthcare fraud and the opioid epidemic. My office shares this commitment and dedication, as illustrated by the successful results we have secured with our outstanding federal, state, and local partners. The South Louisiana Healthcare Fraud Strike Force started in 2009 and continues to be an enormous success in rooting out fraudsters stealing off the backs of hard-working taxpayers, the elderly, and the infirm. I commend our prosecutors and our strike force partners – the U.S. DOJ Fraud Section, HHS-OIG, FBI, and Attorney General Landry’s Medicaid Fraud Control Unit – for their tenacity in bringing the cheats and the scammers to justice. I similarly applaud the outstanding efforts of our many federal, state, and local partners who have joined us in the ongoing battle against an opioid epidemic that has touched far too many lives in our communities. In particular, today’s announcement highlights the extraordinary efforts of the DEA in working with our office and our state and local partners to combat opioid trafficking. Score one for the good guys today. Our fight continues tomorrow.”
Special Agent-in-Charge C.J. Porter of the United States Department of Health and Human Services, Office of Inspector General’s (OIG) Dallas Regional Office, stated, “This takedown is a warning to fraudsters and to those who illegally obtain and distribute opioid drugs that their crimes will be uncovered.” “Along with our law enforcement partners, we will work to ensure that criminals who orchestrate these schemes are brought to justice.”
Eric J. Rommal, Special Agent-in-Charge of the New Orleans Division of the Federal Bureau of Investigation, stated, “Countless Americans are dependent on Medicare and Medicaid as a means to receive essential medical care. Unfortunately, there are individuals and entities who aim to abuse and exploit these programs in the name of greed and selfishness. The FBI, alongside our local, state, and federal partners will continue to aggressively pursue those who commit this fraud especially as it pertains to the ever growing abuse of opioid prescriptions.”
“Today our nation is experiencing a deadly drug epidemic made possible by violent drug traffickers and prescription drug diversion,” said DEA Assistant Special Agent in Charge Brad L. Byerley. “The arrests made over the course of these operations, include doctors, nurses, and pharmacists, as well as street-level dealers. DEA is committed to stopping the abuse of prescription pills at every level. The announcement today should signal to those in the medical community and elsewhere that we will aggressively seek to prosecute anyone who violates our drug laws. These drug traffickers will be brought to justice thanks to the cooperative success of this investigation with our federal, state and local law enforcement partners.”
Louisiana Attorney General Jeff Landry stated, “Medicaid fraud is a devastating crime that steals from our taxpayers and jeopardizes care for our vulnerable who really need assistance. Following our joint investigation with HHS-OIG and the FBI, the U.S. Attorney’s Office was able to achieve an indictment against Mr. Gaines for his alleged illegal activity. I applaud my Medicaid Fraud Control Unit for working to uncover fraudsters and U.S. Attorney Brandon Fremin for joining us to bring criminals to justice.”
NOTE: An indictment is an accusation by the Grand Jury. The defendants are presumed innocent until and unless adjudicated guilty at trial or through a guilty plea.