Home Health Agency Owner and a Physician Found Guilty of Using Recruiters to Commit Health Care Fraud

Two people were convicted of conspiring to defraud Medicare by a jury in Louisiana, and in Texas, a former physician pled guilty to conspiracy to commit health care fraud that resulted in claims totaling more than $19 million to Medicare and the Medicaid program. The activities that lead to the conviction of a home health agency owner and its director of nursing resulted in $17 million in fraudulent bills to Medicare. All three individuals face fines of up to $250,000 and ten years in prison for their crimes.

Louisiana Home Health Agency

Louis Age, the owner of South Louisiana Home Health Care Inc., and his former wife Verna Age, who served as South Louisiana Home Health Care’s director of nursing, paid recruiters to obtain Medicare beneficiary information from people. Mr. Age trained his daughter, Ayanna Age Alverez, to pay recruiters kickbacks for obtaining the information.

Louis Age hired physicians, including Dr. Michael S. Hunter, to sign referrals and certifications for home health services that were not medically necessary. Verna Age falsified and directed others to falsify certification evaluations and other forms to make it appear that home health services were necessary. During the trial, Medicare beneficiaries testified that they did not need the services that South Louisiana Home Health billed to Medicare.

Alverez, Dr. Hunter and Mary L. Johnson a recruiter for South Louisiana Home Health, previously pled guilty and are awaiting sentencing. Sentencing dates have not yet been set for Louis and Verna Age. Louis Age was also convicted of conspiracy to pay health care kickbacks and faces and additional $250,000 penalty and another five years in jail. Another co-defendant, Milton L. Womak, died in July 2012.

Texas Doctor

Donald Gibson, II entered a plea of guilty to the charges of conspiracy to commit health care fraud relating to medically unnecessary diagnostic testing and physical therapy. Gibson ordered, prescribed, and authorized medically unnecessary diagnostic tests and other procedures, such as tests for allergies, pulmonary function tests, vestibular tests, urodynamic tests, physical therapy and other tests.

A co-defendant, Sunday Joseph Edem, pled guilty to the same charge on February, 25, 2013. Edem operated medical clinics under the names of others to conceal his financial interest in the business. Gibson and Edem conspired to pay recruiters for referring Medicare and Medicaid beneficiaries, paying beneficiaries for showing up at the medical clinics, and submitting false claims to Medicare and Medicaid.

Edem is scheduled to be sentenced on May 28th, 2013 and Gibson is set for sentencing on July 1, 2013.