Friday, February 22, 2013
Dallas Couple Sentenced to Prison for Health Care Fraud in Case Investigated by State and Federal OfficialsThe U.S. Attorney for the Northern District of Texas issued the following news release on Feb. 21, 2013:
DALLAS — Two owners of Alliance Healthcare Services, L.P., a Dallas home health care agency, were sentenced today by U.S. District Judge Jane J. Boyle for their roles in a nearly $1.3 million health care fraud conspiracy, announced U.S. Attorney Sarah R. Saldaña of the Northern District of Texas. Richardson, Texas, residents, George Opurum, 62, and his wife, Agatha Opurum, 55, were each sentenced to 37 months in federal prison. They were ordered to surrender to the Bureau of Prisons on March 27, 2013.
George Opurum was the chief financial officer and alternate administrator of Alliance. Edith Opurum was the Director of Nursing at Alliance. Co-conspirator Ernest Amadi, 55, was the chief executive officer of Alliance and his wife, Edith Amadi, 52, was a nurse at Alliance. Alliance was located on Estate Lane in Dallas.
The Amadi’s, residents of Wylie, Texas, also pleaded guilty to conspiracy to commit health care fraud. Edith Amadi was sentenced to 37 months in federal prison; a sentencing date has not been set for Ernest Amadi. Another co-conspirator in the case, Ollie Futrell, 57, of Garland, Texas, pleaded guilty to her role in the conspiracy and is currently serving a 33-month federal prison sentence.
The five defendants in the case billed a total of $1,296,357, and are ordered to pay restitution in the amount of $853,702.
According to documents filed in the case, as part of the conspiracy, from November 2008 through mid-February 2011, Alliance submitted claims to Medicare for home health services purportedly provided to Medicare beneficiaries. Alliance employees, including the owners, falsified Medicare documentation and skilled nursing notes indicating that the patients were homebound and eligible for home health care services. In fact, the majority of Alliance patients were not eligible for the services because they were not homebound. Alliance employees and owners falsified time sheets and patient visit logs for services that were not adequately rendered or were never provided at all. Alliance then billed Medicare as if the services were adequately provided
Further, according to documents filed in the case, Alliance owners conspired with Futrell to recruit Medicare patients for the company so Alliance could increase its Medicare billing and revenue. Futrell, who was paid in cash by Alliance owners, recruited Medicare beneficiaries in a variety of ways and initiated Alliance services for them. She agreed to pay kickbacks — sometimes $100 a month — to patients so that they would continue to use Alliance. Alliance owners knew about, and at times facilitated, these kickbacks.
The case was investigated by the FBI, the Department of Health and Human Services Office of Inspector General (HHS OIG) and the Texas Attorney General’s Medicaid Fraud Control Unit.
Assistant U.S. Attorney Katherine E. Pfeifle of the U.S. Attorney’s Office in Dallas and Trial Attorney Benjamin A. O’Neil of the Fraud Section in the Justice Department’s Criminal Division are in charge of the prosecution.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.