Friday, August 5, 2011

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State and Federal Investigation Leads to Houston Area Health Care Fraud Arrest

The following news release was issued on Aug. 4, 2011, by the United States Attorney for the Southern District of Texas:

Nursing Home Administrator Arrested for Health Care Fraud and Taking Kickbacks

HOUSTON – An employee of a Houston area nursing home has been arrested as a result of the return of a sealed indictment by a Houston grand jury charging him with conspiracy, health care fraud and violations of the anti-kickback statute arising from a scheme to unlawfully bill federal health care programs for ambulance transport, United States Attorney José Angel Moreno, along with Texas Attorney General Greg Abbott announced today.

Kelvin Washington, 47, of Houston, was arrested at his Houston home this morning by investigating agents with the Department of Health and Human Services-Office of the Inspector General, Office of Investigations (DHHS-OIG-OI) and the Texas Medicaid Fraud Control Unit. The indictment was unsealed upon Washington’s arrest. He is expected to make an initial appearance before a U.S. Magistrate Judge in Houston today at 2 p.m., at which time the issue of his release on bond is expected to be raised.

Washington, employed as an administrator at a Sugar Land area nursing home, is accused in the 10-count indictment of having received payments for the referral of dialysis patients to a Houston ambulance transport service between 2003 and 2007. Additionally, Washington is accused of conspiring with others to have unsuspecting doctors sign transport prescriptions for dialysis patients allegedly admitted to the Sugar Land nursing home where Washington works. The indictment alleges, among other matters, that the patients for whom Washington sought the prescriptions were never admitted to the nursing home.

According to the indictment, Medicare and Medicaid were billed almost a $1 million in false claims as a result of Washington’s alleged conduct. For his part in the scheme, Washington allegedly received approximately $20,000.

The statutory maximum penalties for a violation of the health care fraud statute is imprisonment for not more than 10 years. The maximum sentence for a violation of the conspiracy statute or the anti-kickback statute is a maximum of five years. Each of the 10 counts charged also carry a maximum fine of $250,000 as punishment upon conviction.

The charges are the result of the investigative efforts of DHHS-OIG-OI, the Texas Attorney General’s Medicaid Fraud Unit in Houston, the FBI and the United States Attorney’s Office. Special Assistant United States Attorney Suzanne Bradley is prosecuting the case.

An indictment is a formal accusation of criminal conduct, not evidence. A defendant is presumed innocent unless and until convicted through due process of law.