Healthcare Fraud: Tshombe Anderson Pleaded Guilty to One Count of Conspiracy to Commit Health Care Fraud
Dallas Attorney Admits to Role in $26 Million Fraud Conspiracy
DALLAS — Tshombe Anderson, 54, of Grand Prairie, Texas, appeared today before Chief U.S. District Judge Barbara M.G. Lynn and pleaded guilty to a scheme he ran along with four of his family members from July 2011 to September 2015 to fraudulently obtain more than $26 million from the Department of Labor (DOL) Office of Worker’s Compensation Program (OWCP), announced U.S. Attorney John Parker of the Northern District of Texas.
Specifically, Anderson pleaded guilty to one count of conspiracy to commit health care fraud. He faces a maximum penalty of 10 years in federal prison and a $250,000 fine. Restitution could also be ordered. Anderson agrees to forfeit $375,000 seized from his residence, a 2015 Mercedes, and his share of the $8,383,075 that was seized from 25 bank accounts. Anderson will remain in custody pending sentencing which is set for November 29, 2017.
In addition to Anderson, his sister Lydia Bankhead, 63, his wife Brenda Anderson, 47, his sister-in-law Janet Anderson, 43, and his niece Lydia Taylor, 30, were also charged in the indictment returned in September 2015. A trial date of September 25, 2017 has been set for the four co-defendants.
According to plea documents in the case, Tshombe Anderson worked as an attorney for Union Treatment Centers (“UTC”). Anderson and his wife, Brenda Anderson, opened a durable medical equipment company called Best First Administration (“BFA”). BFA was formed, initially, to provide durable medical equipment to patients referred to BFA from UTC. In July 2011, Tshombe Anderson and Brenda Anderson disassociated from UTC.
In April 2013, Tshombe Anderson agreed with Bankhead to open Union Medical Supplies and Equipment (“UMSE”). In August 2013, Tshombe Anderson agreed with Janet Anderson to open Skycare Medical Supplies and Equipment (“SMSE”). Both companies were created in order to submit claims that were inappropriate to OWCP. The same medical information that BFA had received from UTC was used and billed to the same universe of claimants for duplicate, unwanted durable medical equipment that was not medically necessary, using outdated medical information. Tshombe Anderson continued to do so despite knowing that they were billing OWCP for items that were not associated with the claimant’s injuries and that claimants were often refusing or rejecting the durable medical equipment for which their company had billed.
Tshombe Anderson had access to the operating accounts for UMSE and routinely transferred large sums of cash from those accounts for his personal use or to launder through business accounts for a shell company called American Federal Union Claims Advocates, as well as accounts associated with his law office.
The total amount paid to OWCP for UMSE and SMSE was $26,572,458.93.
The DOL Office of Inspector General and the U.S. Postal Service Office of Inspector General investigated the case. Assistant U.S. Attorneys Nicole Dana and P.J. Meitl are in charge of the prosecution.
