Attorney General Loretta E. Lynch and Department of Health and Human Services (DHHS) Secretary Sylvia Mathews Burwell announced today an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings. Twenty-three state Medicaid Fraud Control Units also participated in today’s arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to a number of providers using its suspension authority provided in the Affordable Care Act. This coordinated takedown is the largest in history, both in terms of the number of defendants charged and loss amount.
“As this takedown should make clear, health care fraud is not an abstract violation or benign offense – It is a serious crime,” said Lynch. “The wrongdoers that we pursue in these operations seek to use public funds for private enrichment. They target real people – many of them in need of significant medical care. They promise effective cures and therapies, but they provide none. Above all, they abuse basic bonds of trust – between doctor and patient; between pharmacist and doctor; between taxpayer and government – and pervert them to their own ends. The Department of Justice is determined to continue working to ensure that the American people know that their health care system works for them – and them alone.”
“The largest multiple defendant takedown of those who were involved in large scale health care fraud against the USA sends a tremendous message to the public of our vigilance. Such wrongdoing will be uncovered and prosecuted,” said U.S. Attorney Kenneth Magidson. “These cases are part of our continuing effort to combat greed in our health care system, not only in the Houston metropolitan area, but also in our other offices in South Texas. We are committed to a sustained effort to continue to root out health care fraud.”
In the Southern District of Texas (SDTX), the United States Attorney’s Office (USAO) and the Department of Justice Medicare Fraud Strike Force charged 22 individuals in 11 cases involving over $136 million in alleged fraud.
One of these defendants is a physician with the highest number of referrals to home health services in the SDTX. Houston physician John Ramirez, 62, has been charged with participating in separate schemes to bill Medicare for medically unnecessary home health services that were often not provided. He is charged with four counts of conspiracy to commit health care fraud. In this $18 million Medicare fraud scheme, Ramirez allegedly authorized home-health services for Medicare beneficiaries when such services were not medically necessary, not provided by the home health agency or both. Medicare paid over $15 million to numerous companies that submitted claims to Medicare using the fraudulent home health referrals from the physician, according to the indictment. Also charged in this case is Susana Bermudez, 49, of Houston, the owner of Milten Clinic in Houston. She was indicted on one count of conspiracy to commit health care fraud for allegedly selling signed certifications to home health agencies. The agencies then would bill Medicare for purported home health services that were medically unnecessary, not provided, or both.
In a separate but related case, Ramirez, Ann Sheperd, 60, of Houston, and Yvette Nwoko, 27, of Houston, were indicted on one count of conspiracy to commit health care fraud and three counts of health care fraud. The charges stem from their alleged roles in an $20 million Medicare fraud scheme. Sheperd was the owner and operator of Amex Medical, while Nwoko was the manager. The indictment alleges Shepherd and Nwoko would make it appear as if Medicare beneficiaries qualified for home health services when, in fact, the beneficiaries did not need the services. Shepherd allegedly paid doctors to sign false certifications. In return, Shepherd and Nwoko would sell the certifications to home health agencies, according to the charges. These agencies would then bill Medicare for home health services that were not necessary, not provided, or both.
These cases are being jointly prosecuted by the USAO and the Strike Force.
In another case prosecuted by the USAO, Gwendolyn Arnetta Gibbs aka Gwendolyn Arnetta Guidry, 64, of Missouri City, and Justina Obumnador Uzowulu, 55, are charged in a 20-count indictment for their participation in a $15 million health care fraud conspiracy. Gibbs is the owner and operator of Daybreak Rehabilitation Center. The indictment alleges he paid kickbacks to Uzowulu, who operates a group home in Houston, who would then bring her residents to Gibbs’ partial hospitalization program for group therapy. Gibbs could then bill Medicare for treatment, according to the indictment. Gibbs is also charged with billing group therapy sessions under a doctor who no longer worked at Daybreak.
In McAllen, the owner of a Rio Grande Valley area durable medical equipment (DME) company and six others have been charged in a 16-count indictment for allegedly submitting false and fraudulent claims to Texas Medicaid for DME equipment that was not provided and/or was not authorized by a physician. Maria Garza, 41, of McAllen, is an owner of DME company Hacienda DME. Also charged were employees Bertha Lopez, 61, of Sullivan City, who served as a marketer and vendor for the company; Miriam Aguilar, 31, of Rio Grande City, a delivery driver and recruiter; and Nancy Rangel, 30, of Mission, who was a biller and recruiter. Veronica Cruz, 32, of Donna, Angelica Saenz, 44, of Mission, and Yolotzi Lara, 28, of Penitas, were charged for their roles as recruiters for Hacienda DME. According to the indictment, the defendants forged and/or caused others to forge the signatures of physicians on the required prescription forms. They also allegedly billed for larger, higher-paying sizes of pull-ups and diapers regardless of whether those sizes were needed or provided in order to receive higher reimbursements from Texas Medicaid. Further, the defendants also paid illegal kickbacks in exchange for patient information, according to the indictment.
Additionally, the Strike Force has returned seven additional indictments and informations in the SDTX, charging nine more defendants in cases involving over $80 million.
The operations announced today 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. The Medicare Fraud Strike Force operates in nine locations and since its inception in March 2007 has charged over 2,900 defendants who collectively have falsely billed the Medicare program for over $8.9 billion.
Including today’s enforcement actions, nearly 1,200 individuals have been charged in national takedown operations, which have involved more than $3.4 billion in fraudulent billings. Today’s announcement marks the second time that districts outside of Strike Force locations participated in a national takedown, and they accounted for 82 defendants charged in this takedown.
The cases announced today are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with Medicare Fraud Strike Force teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices of the Southern District of Florida, Eastern District of Michigan, Eastern District of New York, Southern District of Texas, Central District of California, Eastern District of Louisiana, Northern District of Texas, Northern District of Illinois and the Middle District of Florida; and agents from the FBI, DHHS-Office of Ispector General, Drug Enforcement Administration, Defense Criminal Investigative Service and state Medicaid Fraud Control Units.
The court documents for each case will posted online, as they become available, here:
My name is David Anderson. I want to make the world smile…
About three months ago I needed a SMILE after losing someone close to me. What I would do to see them smile again. As I sat in church one Sunday morning I began to feel guilty for feeling down because I have way too much to be thankful for. So as I began to dwell on my many blessings I thought to myself how blessed I am to live and thrive off of a career that is my passion. Since the age of 16 I have enjoyed throwing some really great parties and events. This thought took me to why do I enjoy throwing parties and events, I realized it has more to do with the pleasure and fullfilment of moving people to enjoying themselves and SMILE! WOW, my aha moment! My purpose in life is to make people SMILE. What a gift from God!?!?
This brings me back to the beginning of the story… What I would do to see my friend smile again? I would gladly turn every frown upside down, perhaps raise 1 billion SMILES in hopes that somewhere and some way these 1 billion SMILES could bring me the one smile I lost.
I am seeking to raise $10,000 to help fund the startup expenses associated with starting my foundation, A Billion Smiles. A Billion Smiles’ mission is to get 1 billion people to smile through charitable giving, acts of kindness and “paying it forward”. In our first year we will make contributions to nonprofit organizations that do cancer research, alzheimers/dementia research, mental health research, and fight alcohol & drug abuse. The way we see it if we can better the lives of people affected by any of these causes we are bringing smiles to them and the people that love them.
There is nothing more rewarding then a SMILE. The warm and fuzzies shared by both the benefactor and beneficiary is equally rewarding. “In a study conducted in the UK (using an electromagnetic brain scan machine and heart-rate monitor to create “mood-boosting values” for various stimuli), British researchers found that one SMILE can provide the same level of brain stimulation as up to 2,000 chocolate bars; they also found that smiling can be as stimulating as receiving up to 16,000 Pounds Sterling in cash. That’s 25 grand a smile… it’s not bad…at 400 daily smiles quite a few children out there feel like Mark Zuckerberg every day!” (http://www.forbes.com/sites/ericsavitz/2011/03/22/the-untapped-power-of-smiling/ )
I want everyone to feel like a billionaire, so I hope you will help make me a SMILEionaire… Thank you for your time and consideration. I am SMILING right now are you?
On Friday, June 17, 2016, detention personnel with the Harris County Sheriff’s Office responded to an attempted suicide at the 1200 Baker Street Jail.
At approximately 8:05 PM a male inmate secluded himself in a shower area in a Medical Detoxification tank, and attempted suicide by hanging. The staff was notified of the inmate’s attempt, and immediately responded with emergency equipment designed to safely cut ligature devices. Detention staff immediately began resuscitative procedures as medical staff was summoned to the scene. HCSO Medical Staff and Houston Fire Department personnel continued CPR until the inmate’s blood pressure, pulse and breathing were restored. The individual was transported by HFD to St. Joseph Medical Center, where he remains in critical condition.
The inmate was booked into custody on June 13, 2016, for felony charges of Assault-Bodily Injury/Family Member. The State prescribed intake screening was performed, and no indicators of suicidal ideation were noted.
Harris County Sheriff Ron Hickman has ordered an immediate Internal Affairs investigation into any possible violations of policy or procedure. “Should any indication of failure to adhere to our strict policies or procedures become evident, I will use the full power of my office to retrain or if necessary reprimand staff involved,” stated Hickman. “The care, custody, control and safety of inmates in our custody are charged to all employees working in the Harris County Jail.
“Unfortunately attempted suicide is an unwelcome reality of the jail environment. In 2015 there were 186 attempted suicides, and year to date in 2016 there have been 130 attempted suicides. No deaths in custody are acceptable, and I have dedicated my administration to improving the standards of care for Harris County inmates.
“Harris County averages a per capita jail suicide rate of 13 per 100,000. The National average is 46 per 100,000. I grieve for the circumstances that lead any person to attempt to take their own life, and pray for the family of the inmate involved in this attempted suicide.”
A three year breakdown of suicide attempts is listed below:
2016 – 130 Suicide Attempts
2015 – 186 Suicide Attempts, 1 death caused by Suicide
2014 – 154 Suicide Attempts, 3 deaths cause by Suicide.
Carolyn Conner, who’s 9 years old, made a card and dropped it off at the Patton Village police department today.
We spoke to the 9 year old about the importance of remembering a fallen hero.
More details today at 5 pm on #Fox26News !
Former Montgomery County 1st Assistant District Attorney Phil Grant has received a helluva promotion.
The former prosecutor was elected to replace outgoing 9th Judicial District Court Judge Kelly Case in Montgomery County.
While Case’s term doesn’t expire until December, the controversial Judge made it clear he was leaving in June…six months early.
The Governor’s office appointed Phil Grant as interim judge even thought he won the seat and was officially set to take office in January.
Grant was sworn in Monday morning and he says now it’s time to get to work in the felony court.
Houston police have released surveillance video of two suspects wanted in a game room robbery at 10301 Club Creek about 9 p.m. on May 6.
The suspects are described only as black males, 25 to 30 years of age. One suspect is about 6 feet tall, weighing 180 to 200 pounds. He was wearing a dark-colored hoodie and camouflaged shorts. The other suspect is about 5 feet 9 inches tall, weighing 160 to 170 pounds and wore a dark-colored T-shirt and light-colored shorts.
Surveillance video of the suspects can be viewed on the HPD YouTube channel at https://youtu.be/bMi-NTPFB5Y. Surveillance photos of the suspects are attached to this news release.
The two suspects, armed with handguns, entered the Variety Game Room at the above address and approached a security guard with his back turned and speaking with a customer. The suspects disarmed the security guard and then robbed various customers at gunpoint. The suspects then fled the location in a waiting vehicle, described only as a white SUV type vehicle, driven by a third suspect of unknown race or gender.
Anyone with information in this case is urged to contact the HPD Robbery Division at 713-308-0700 or Crime Stoppers at 713-222-TIPS.
Houston Fire Department Cadet Classes 2016-B and 2015-G graduation ceremony.
When: Tonight, June 16, 2016 at 6:30 p.m.
Where: Houston Community College Central Campus, San Jacinto Memorial Building Auditorium, 1300 Holman Street, 77004
Additional Information: 12 Cadets from HFD Class 2016B and 39 Cadets from HFD Class 2015G will graduate from the Houston Fire Department Training Academy during the graduation ceremony. Interim Fire Chief Rodney West will give the oath of office to the cadets.
A Civil Service Exam for Firefighter Trainee is scheduled for August 24, 2016. For more information about this exam and registration go to www.hfdcareers.org or call 832-394-6600.
A new unit is roaming the halls of the Harris County Jail to ensure a safe and secured environment for nearly 9,000 inmates and 1,500 employees.
This morning, the Criminal Justice Bureau’s K-9 Operations Team conducted an operation to search select cells for contraband and narcotics.
On Thursday, Sheriff Ron Hickman joined the Criminal Justice and Personnel Resources Bureau K-9 Operations Team as it responded to a tip that narcotics and other contraband may be present in a cellblock at the Sheriff’s 1200 Baker Street Jail.
The K-9 Operations Team was formed by Sheriff Hickman in February of 2016 in order to improve upon existing resources dedicated to the detection and removal of contraband from the secured Harris County Jail.
Lt. Tommy Shelton oversees the operation managed by SGT David Cruzan and DEP Jeremy Sanchez.
K-9 Deputy “Vito” is a single purpose narcotics detection dog that was donated to the Sheriff’s Office by the 501(c)(3) organization K9s 4COPS.
The team is working to add an additional K-9 used to detect electronic media storage devices and cell phones.
For full details, view this message on the web.
The Houston chapter of the Council on American-Islamic Relations (CAIR- Houston) today welcomed a decision by City Council Member Mike Knox to terminate a member of his staff who tried to block a Muslim from a Republican Party post because of the staffer’s hostility to Islam.
At a meeting of the Harris County Republican Party last month, Trebor Gordon asked that the Muslim party member be removed from consideration as a precinct chair, “on the grounds that Islam does not have any basis or any foundation- it is in total opposite of our foundation.” During that meeting, Gordon also stated, “Islam and Christianity do not mix.”
Last week, representatives of CAIR-Houston, along with other Muslim and Interfaith activists and leaders, met with Council Member Knox and called for a full apology from Gordon, sensitivity training for Knox’s staff and for a city council resolution denouncing Islamophobia and religious intolerance.
Knox agreed to those requests and called for a subsequent meeting to inform the group of his decision. It was during that meeting that Knox informed the group of his decision to terminate Gordon.
Some Houstonians have found another way to give back and that’s one pair at a time.
Corey Alexander Crear of SNKR Critique held his first monthly sneaker drive in downtown Houston at Dean’s Tuesday night.
Supporters of the event donated more than 70 pair of gently used sneakers and they’re going to those who can truly use them.
Crear says, “it’s giving to someone who’s unable to purchase that on their own and with us doing something for them hopefully that will help them do something positive for yourself.”
Jermaine Patterson also showed up to the event as a sneaker enthusiast. He decided to turn over a pair of shoes because he says it’s the right thing to do.
The shoes collected this month will go to the young people at the Covenant House.
If you would like to get involved make sure you contact Corey at SNKRCRITIQUER@GMAIL.COM