Wednesday, February 13, 2008

Why blamed undocumented Immigrants for burden the medicare and Social Services programs? I had been exposed many cases of Medicare and social services frauds as well as the 47Millions of people uninsured that are part of the equation. Why???.

Another case Woman pleads guilty to conspiracy to defraud Medicare of aproximately $ 36.9 Millions.

(HOUSTON, Texas) - Khira Guillory, 27, has pleaded guilty to one count of conspiracy to defraud Medicare of approximately $36.9 million, United States Attorney Don DeGabrielle announced today. At the time of the criminal activity, Guillory was the owner of KJB Medical Billing, an authorized Medicare billing company.

At a hearing held yesterday before U.S. District Judge Gray H. Miller, Guillory admitted she participated in a 13-month conspiracy with several other individuals, including Rhonda Fleming, to defraud Medicare by repeatedly billing Medicare for Durable Medical Equipment (DME) which was never supplied to the Medicare beneficiaries as claimed. According to the indictment, at the time of the criminal activity, Fleming, 42, owned her own Medicare billing company, Advanced Medical Billing Specialists, as well as three DME supply companies, Medical Equipment and Supply Center (MESC), Hi-Tech Medical Supply & Delivery (Hi-Tech) and E&R Medical Supply (E&R).

During her plea, Guillory admitted to billing Medicare for approximately $7.4 million of DME which she knew had never been delivered to the Medicare beneficiaries. She also admitted that all but $12,600 of the claims she filed contained fictitious dates of service that were backdated to make it appear the DME had been delivered six to 23 months prior to the date she filed the claim. For example, Guillory admitted that on Nov. 17, 2004 , she filed claims totaling $1,054,000 on behalf of 111 Medicare Beneficiaries for an Infrared Heating Pad System and a Power Pressure Reducing Air Mattress with dates of service ranging from January to September 2003.

Based on Guillory's fraudulent billing, Medicare and Medicaid paid approximately $2,500,284 to DME companies owned by Fleming and other co-conspirators. Guillory also admitted to receiving $483,868.92 from Fleming for filing the false billings.

Guillory is scheduled to be sentenced April 25, 2008 , and faces a maximum penalty of five years imprisonment and a $250,000 fine for her conspiracy conviction. As part of her plea agreement, Guillory also agreed to pay restitution of $2,500,284 to Medicare.

Guillory and Fleming are charged in a 73-count indictment with four other individuals which alleges a scheme involving the filing of millions of dollars in claims with Medicare/Medicaid by DME companies for durable medical equipment, such as infrared heating systems, pressure reducing mattresses and lumbar supports, which they purportedly supplied to Medicare beneficiaries, but were never purchased by the DME company nor delivered to the beneficiary.

Also charged in that indictment with conspiracy to defraud Medicare are Bose Ebhamen, 41, Billy Perkins, 48, James Chaney, 44, and King Arthur, 53. Fleming, Ebhamen, Perkins, Chaney and Arthur are also charged with multiple counts of healthcare fraud and wire fraud. Three of the defendants, Fleming, Ebhamen and Chaney, are also charged with various counts of money laundering.

According to allegations in the indictment, Fleming purchased Medicare beneficiary information, including their names and Medicare numbers, from Chaney and others for use in the scheme. Perkins and other employees of Fleming created fictitious delivery tickets to give the appearance the DME had been delivered by Hi-Tech, First Advantage and E&R. Perkins allegedly also mislead Medicare by pretending to be the person Medicare thought was the owner of E&R Medical Supply, located in Lake Charles, La. Fleming and her five co-defendants' fraud scheme caused Medicare/Medicaid to pay out approximately $6.5 million in fraudulent claims.

During the Fall of 2005, the United States seized and forfeited approximately $1.8 million of the illegal Medicare/Medicaid proceeds obtained during the alleged conspiracy to defraud Medicare charged in this indictment. The indictment also seeks to forfeit the $6.5 million from the six defendants as proceeds of the fraudulent scheme.

Fleming and the remaining four defendants are scheduled for trial beginning Feb. 25, 2008 . The public is reminded that an indictment is a formal accusation of criminal conduct, not evidence. The defendants are presumed innocent unless convicted through due process of law.

The criminal charges are the result of a joint investigation conducted by agents of the U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations, the Internal Revenue Service Criminal Investigation Division, the FBI and the Medicare Fraud Control Unit of the Texas Attorney General's Office. This case is being prosecuted by Assistant United States Attorney Al Balboni and Special Assistant United States Attorney Suzanne Bradley

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