Texas Physician Convicted in $16 Million Medicare Fraud Scheme
A federal jury in Texas found a physician who was the owner and operator of a medical clinic in Houston, Texas, guilty today of participating in a $16 million Medicare fraud scheme in which she signed false and fraudulent “plans of care” and other medical documents for purported home health services.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ryan Patrick of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of the Inspector General’s (HHS-OIG) Dallas Regional Office made the announcement.
Following a six-day trial, Yolanda Hamilton, M.D., 56, of Harris County, Texas, the owner and operator of HMS Health and Wellness Center, PLLC, was convicted of one count of conspiracy to commit health care fraud, one count of conspiracy to solicit and receive health care kickbacks and two counts of false statements relating to health care matters. Hamilton is expected to be sentenced before U.S. District Judge Keith P. Ellison of the Southern District of Texas, who presided over the trial. A sentencing date has not yet been set.
According to the evidence presented at trial, from January 2012 to August 2016, Hamilton and others conspired to defraud Medicare by signing false and fraudulent plans of care and other medical documents, and submitting fraudulent claims to Medicare to make it falsely appear that the patients of Hamilton and her co-conspirators qualified and received home-health services under Medicare. In fact, Hamilton and her co-conspirators paid the patients to sign-up and recertify for home health services when those services were often not medically necessary, not provided or both. The evidence also showed that Hamilton charged home health agencies an illegal kickback in the form of a patient “fee” for certifying and recertifying patients for home-health services that the home health agencies, not the patients, would pay. The scheme resulted in approximately $16 million in false and fraudulent claims for home-health services to Medicare, the evidence showed.
Read more: https://www.justice.gov/opa/pr/texas-physician-convicted-16-million-medicare-fraud-scheme
