Six Individuals Face 47-Count Second Superseding Indictment for Health Care Services Fraud
U.S. Attorney Kenneth A. Polite announced that a Federal Grand Jury has returned a 46-count superseding indictment against six individuals charging approximately $13,655,094 in Medicare fraud.
Specifically, HENRY EVANS, age 71; MICHAEL JONES, age 47; PAULA JONES, age 45;SHELTON BARNES, age 62; GREGORY MOLDEN, age 60, all of New Orleans and JONATHON NORA, age 29, of River Ridge, were indicted yesterday for conspiracy to commit health care fraud, conspiracy to defraud the United States and to receive and pay health care kickbacks, and health care fraud. BARNES was also charged with obstruction of a federal audit.
The Indictment is the third one involving many of the same parties who were originally indicted in March of 2015. Nineteen individuals and/or companies have already pled guilty to charges associated with the original Indictment.
This Second Superseding Indictment is related to the Indictment returned in March 2015 charging Lisa Crinel and others, some of whom have entered guilty pleas. According to the Second Superseding Indictment, the defendants participated in a criminal organization for the purpose of fraudulently billing Medicare for medically unnecessary home health services for patients who were not homebound. DRS.BARNES, EVANS, MOLDEN and MICHAEL JONES, known as “House Doctors,” ordered home health services for Medicare beneficiaries who had no legitimate medical necessity. The House Doctors falsely signed home health orders regardless of the beneficiary’s needs, homebound status, or diagnoses. In return, DRS. BARNES, EVANS, and MOLDEN received monthly payments fraudulently characterized as medical consultant or director fees for which they provided no services other than fraudulently certifying Medicare beneficiaries for unnecessary home health services. Instead of receiving monthly payments from the home health agency, Abide hired PAULA JONES, DR. MICHAEL JONES’ wife and, thereafter, inflated salary payments to PAULA JONES represented MICHAELJONES’ fees for fraudulently certifying home health for ineligible Medicare beneficiaries.
Marketers contacted JONATHON NORA and others to confirm that the person fraudulently referred for home health was a Medicare beneficiary. Once NORA determined the referred individual was a Medicare beneficiary, NORA scheduled a physician visit, usually with an Abide House Doctor, well knowing that the individual referral to Abide was by a Marketer, instead of the beneficiary’s own health care professional.
Abide generated plans of care reflecting the falsely created assessments. The plans of care were given toDRS. BARNES, EVANS, MOLDEN and MICHAEL JONES to falsely certify and recertify medically unnecessary episodes of home health. PAULA JONES fraudulently billed Medicare, on behalf of Abide,for the medically unnecessary home health services.
The Superseding Indictment also charges SHELTON BARNES with obstruction of a federal audit in connection with his billing to Medicare Part B of services related to the medically unnecessary home health services.
If convicted, DR. SHELTON BARNES faces a possible maximum sentence of 170 years imprisonment;DR. HENRY EVANS faces a possible maximum sentence of 95 years imprisonment; DR. GREGORY MOLDEN faces a possible maximum sentence of 115 years imprisonment, and DR. MICHAEL JONESfaces a possible maximum sentence of 125 years imprisonment. If convicted, JONATHAN NORA faces a possible maximum sentence of 25 years imprisonment and PAULA JONES faces a possible maximum sentence of 15 years imprisonment. For each count for which any defendant is convicted, they are subject to a maximum $250,000 fine.
U.S. Attorney Polite reiterated that the Indictment is merely a charge and that the guilt of the defendants must be proven beyond a reasonable doubt.
U.S. Attorney Polite praised the work of the Special Agents of the Federal Bureau of Investigation in investigating this matter. Assistant U.S. Attorneys Patrice Harris Sullivan, Hayden Brockett, Maria Carboni, and Sharan Lieberman are in charge of the prosecution.
Tags: Healthcare Fraud