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May 5, 11

NEWS / Houston Federal Jury Convicts Four Defendants in Connection with $5.2 Million Medicare Fraud Scheme


To Date, 11 Individuals Guilty of Federal Crimes for Roles in Scheme

WASHINGTON Ė A federal jury in Houston convicted four defendants today in connection with a $5.2 million Medicare fraud scheme that operated from April 2006 to August 2009, announced the Departments of Justice and Health and Human Services (HHS), the FBI and the Texas Attorney General.



Ezinne Ubani, 46, of Houston, and Mary Ellis, 55, of Missouri City, Texas, were each convicted of one count of conspiring to commit health care fraud, and two counts of making false statements for use in determining rights for benefit and payment by Medicare. Ellis was also convicted of one count of conspiring to receive illegal kickbacks for referring Medicare beneficiaries, and three counts of receiving illegal kickbacks for referring Medicare beneficiaries.



Caroline Njoku, 45, of Houston, was convicted of one count of conspiring to commit health care fraud and one count of conspiring to receive kickbacks for referring a Medicare beneficiary. Njoku was found not guilty of one count of receiving illegal kickbacks for referring a Medicare beneficiary. Terrie Porter, 47, of Houston, was convicted of one count of conspiring to receive illegal kickbacks for referring a Medicare beneficiary and one count of illegally receiving a kickback for referring a Medicare beneficiary. Estella Joseph, 62, of Houston, was found not guilty of one count of conspiring to receive kickbacks for referring a Medicare beneficiary, and not guilty of one count of receiving an illegal kickback for referring a Medicare beneficiary



The four defendants were convicted after a 15-day trial before U.S. District Court Judge Nancy Atlas in Houston. According to the evidence presented at trial, Family Healthcare Group, a Houston home health care company, purported to provide skilled nursing to Medicare beneficiaries. Family Healthcare Group hired Njoku, Ellis, Porter and other co-conspirators to recruit Medicare beneficiaries for the purpose of filing claims with Medicare for skilled nursing that was medically unnecessary and/or not provided. After the Medicare beneficiaries were recruited, Ubani, a registered nurse, and other co-conspirators fraudulently signed plans of care stating that the beneficiaries needed home health care when in fact they knew the beneficiaries were not home-bound and not in need of skilled nursing.



Ubaniís husband, Clifford, and Njokuís husband, Princewill, were co-owners of Family Healthcare Group and they both previously pleaded guilty to conspiring to commit healthcare fraud and conspiring to paying illegal kickbacks for referring Medicare beneficiaries. Additionally, Adelma Casas-Sevilla, a registered nurse employed by Family Healthcare Group, previously pleaded guilty to conspiring to commit healthcare fraud. Sammie Wilson and Cynthia Garza-Williams, both patient recruiters for Family Healthcare Group, also pleaded guilty to conspiring to commit healthcare fraud. Erica Walker and Florida Holiday Island, both patient recruiters for Family Healthcare Group, pleaded guilty to conspiring to receive illegal kickbacks for referring a Medicare beneficiary and illegally receiving a kickback for referring a Medicare beneficiary. Family Healthcare Group is no longer in business.



At sentencing, scheduled for July 20 and 21, 2011, the defendants face maximum penalties of 10 years in prison for the health care fraud conspiracy count; five years in prison for making false statements for use in determining rights for benefit and payment by Medicare; five years in prison for conspiring to receive illegal kickbacks for referring Medicare beneficiaries; and five years in prison for receiving an illegal kickback for referring a Medicare beneficiary.



Todayís guilty verdicts were announced by Assistant Attorney General Lanny A. Breuer of the Justice Departmentís Criminal Division; U.S. Attorney José Angel Moreno of the Southern District of Texas; Special Agent-in-Charge Richard C. Powers of the FBIís Houston Field Office; Special Agent-in-Charge Mike Fields of the Dallas Regional Office of HHS Office of Inspector General (HHS-OIG), Office of Investigations; and Texas Attorney General Greg Abbott.



This case is being prosecuted by Trial Attorneys Charles D. Reed and Sarah Hall, and Assistant Chief Sam S. Sheldon of the Criminal Divisionís Fraud Section. The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorneyís Office for the Southern District of Texas and the Criminal Divisionís Fraud Section.



Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,000 defendants who collectively have falsely billed the Medicare program for more than $2.3 billion. In addition, HHSís 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 Action Team (HEAT), go to: www.stopmedicarefraud.gov .

http://www.justice.gov/opa/pr/2011/May/11-crm-572.html

 




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