New Orleans Business Owner and Doctor Sentenced to Prison for Roles in $34 Million Medicare Fraud Scheme
The owner of a New Orleans medical service company and a doctor who served as the company’s medical director were sentenced to prison today for their involvement in a $34 million Medicare fraud scheme.
Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Kenneth A. Polite of the Eastern District of Louisiana, Special Agent in Charge Jeffrey S. Sallet of the FBI’s New Orleans Field Office and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Dallas Regional Office made the announcement.
Elaine Davis, 60, of New Orleans, and Pramela Ganji, M.D., 67, of Harahan, Louisiana, were sentenced to 96 months and 72 months in prison, respectively. Chief U.S. District Judge Kurt D. Engelhardt of the Eastern District of Louisiana imposed the sentences and scheduled a hearing to determine restitution owed by both defendants for Dec. 7, 2016. On March 17, 2016, a jury convicted Davis and Ganji each of one count of conspiracy to commit health care fraud and one count of health care fraud.
According to evidence introduced at trial, Davis directed a massive fraud scheme through Christian Home Health Inc. (Christian), a company that used elderly and disabled Medicare recipients in New Orleans and adjacent communities to fraudulently bill Medicare for purported home health care services. Ganji served as Christian’s medical director from 2010 through 2015. Evidence presented at trial showed that the vast majority of these patients did not require home health care services, and that Ganji falsely claimed that beneficiaries she had never examined were qualified to receive these services.
The evidence at trial demonstrated that Davis and Ganji caused Christian to bill Medicare for more than $34.4 million in claims, a vast percentage of which were fraudulent. Medicare paid more than $29.6 million on these claims.
The FBI and HHS-OIG investigated the case. Trial Attorneys William Kanellis, Antonio Pozos and Drew Bradylyons of the Criminal Division’s Fraud Section prosecuted the case.