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October 18, 10

NEWS / 7 More Houston-area Residents Charged in $5 Million Health Care Fraud Scheme


Total of 14 Defendants Now Charged for Alleged Roles in Scheme

WASHINGTON Ė Seven additional Houston-area residents who allegedly served as patient recruiters and a nurse have been charged for their alleged participation in a $5 million Medicare home healthcare fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced today. The defendants were scheduled to make their initial appearances yesterday and today in U.S. District Court in Houston before Magistrate Judge Stephen Wm. Smith.

A superseding indictment filed Oct. 7, 2010, and unsealed today in U.S. District Court in Houston charges Clifford Ubani, 52; Ezinne Ubani, 45; Princewill Njoku, 51; Caroline Njoku, 45; Mary Ellis, 54; Michelle Turner, 42; Cynthia Garza-Williams, 49; Adelma Casas Sevilla, 44; and Sammie Wilson, 69, with conspiracy to commit health care fraud. Florida Holiday Island, 50; Margaret Pleasant, 45; Estella Joseph, 61; Terrie Porter, 47; and Erica Walker, 30, are charged with conspiracy to pay or receive kickbacks, along with Clifford Ubani, Princewill Njoku, Caroline Njoku, Ellis, Turner and Garza-Williams. These defendants are also charged with individual counts relating to the payment and receipt of kickbacks. Ezinne Ubani, Princewill Njoku and Ellis are also charged with making false statements in the submission of claims to the Medicare program. Clifford Ubani, Ezinne Ubani, Princewill Njoku, Caroline Njoku, Ellis, Turner and Garza-Williams, were charged in the original indictment filed on June 21, 2010.

According to the superseding indictment, Clifford Ubani, Ezinne Ubani, Princewill Njoku and Caroline Njoku were the owners and operators of Family Healthcare Services. The superseding indictment alleges that these owners and operators submitted false and fraudulent claims to the Medicare program for purportedly providing home health care services that were not medically necessary and/or not rendered. According to the superseding indictment, the Medicare program paid Family Healthcare Services approximately $5 million based on the false and fraudulent claims.

Caroline Njoku, Ellis, Turner, Garza-Williams, Wilson, Island, Pleasant, Joseph, Porter and Walker allegedly recruited Medicare beneficiaries to be placed at Family Healthcare Services for skilled nursing services, and in return allegedly were paid kickbacks by Clifford Ubani, Princewill Njoku and others for the referrals. According to the superseding indictment, Ezinne Ubani, Princewill Njoku, Ellis, Garza-Williams and Sevilla allegedly falsified or helped falsify patient files to make it appear that Medicare beneficiaries qualified for and received home health care services that were not medically necessary and/or not provided.

The maximum sentence for committing health care fraud is 10 years in prison. The maximum sentence for conspiracy to pay or receive kickbacks, each individual count of paying and/or receiving kickbacks, and making false statements in determining rights for benefit and payment by Medicare is five years in prison. The superseding indictment seeks forfeiture of assets held by the defendants.

An indictment is merely a charge and the defendants are presumed innocent until proven guilty.

Todayís charges were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney José Angel Moreno of the Southern District of Texas; Special Agent-in-Charge Richard C. Powers of the FBIís Houston field office; Special Agent-in-Charge Mike Fields of the Dallas Regional Office of HHS Office of the Inspector General (HHS-OIG), Office of Investigations; and the Texas Attorney Generalís Medicaid Fraud Control Unit (MFCU).

This case is being prosecuted by Trial Attorneys Charles D. Reed and Sam S. Sheldon of the Criminal Divisionís Fraud Section. The case was investigated by the FBI, HHS-OIG and MFCU, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Divisionís Fraud Section and the U.S. Attorneyís Office for the Southern District of Texas.

Since their inception in March 2007, Medicare Fraud Strike Force operations in seven districts have obtained indictments of more than

810 individuals who collectively have falsely billed the Medicare program for more than $1.85 billion . In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

http://www.justice.gov/opa/pr/2010/October/10-crm-1156.html

 




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