Group Home Owners Convicted in $1 Million Medicare Fraud Scheme | OPA

A federal jury convicted a Texas partner and wife yesterday for a $1 million Medicare fraud plan, including violations of the federal Anti-Kickback Statute.

In accordance to court documents and proof introduced at trial, Lindell King, 52, and Ynedra Diggs, 44, each of Missouri Town, were client recruiters who owned and operated group houses in which Medicare beneficiaries lived. In trade for sending their group household inhabitants to Behavioral Drugs of Houston (BMH), a group psychological well being center that purported to give partial hospitalization companies, BMH paid out Diggs, King, and other affected person recruiters kickbacks in hard cash and by examine, normally hid as payment for “transportation” or other sham solutions. About the training course of the conspiracy, BMH billed roughly $1 million to Medicare based mostly on kickbacks paid out to Diggs and King.

Both Diggs and King were being convicted of a conspiracy to defraud the United States and to pay out and acquire wellbeing care kickbacks, and a number of substantive violations of the Anti-Kickback Statute. Diggs and King are each scheduled to be sentenced on Aug. 4. King faces up to 20 yrs in prison on all expenses and Diggs faces up to 15 yrs in prison on all prices. A federal district court docket decide will determine any sentence immediately after contemplating the U.S. Sentencing Recommendations and other statutory factors.

Assistant Legal professional Typical Kenneth A. Polite Jr. of the Justice Department’s Criminal Division U.S. Lawyer Jennifer B. Lowery of the Southern District of Texas Specific Agent in Demand Miranda Bennett of the Division of Health and fitness and Human Companies Business of Inspector General’s (HHS-OIG) Dallas Area Assistant Director Luis Quesada of the FBI’s Prison Investigative Division Specific Agent in Charge James H. Smith III of the FBI’s Houston Subject Business office and Important William Marlowe of the Texas Attorney General’s Medicaid Fraud Management Device (MFCU) manufactured the announcement.

The HHS-OIG, FBI, and MFCU investigated the case.

Trial Lawyers Monica Cooper and Brynn Schiess of the Felony Division’s Fraud Area are prosecuting the case.

The Fraud Section qualified prospects the Legal Division’s attempts to battle health treatment fraud by means of the Wellbeing Treatment Fraud Strike Force Plan. Since March 2007, this software, comprised of 15 strike forces working in 24 federal districts, has billed extra than 4,200 defendants who collectively have billed the Medicare program for a lot more than $19 billion. In addition, the Centers for Medicare & Medicaid Expert services, performing in conjunction with the Office of the Inspector Basic for the Section of Wellness and Human Companies, are using techniques to maintain vendors accountable for their involvement in health treatment fraud strategies. Far more info can be identified at https://www.justice.gov/prison-fraud/overall health-care-fraud-unit.

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