Monday, April 1, 2013
Houston-area Man Convicted of Health Care Fraud in Case Investigated by State and Federal OfficialsThe U.S. Attorney for the Southern District of Texas issued the following news release on April 1, 2013:
HOUSTON – Donald Gibson II, 56, of Richmond, has been convicted of conspiracy to commit health care fraud relating to medically unnecessary diagnostic testing and physical therapy, United States Attorney Kenneth Magidson announced today.
Gibson entered a plea of guilty just minutes ago, admitting he conspired to commit health care fraud along with co-defendant, Sunday Joseph Edem, 53, also of Richmond.
Gibson ordered, prescribed and authorized medically unnecessary diagnostic tests and other procedures which included allergy tests, pulmonary function tests, vestibular tests, urodynamic tests and physical therapy, among others. These services were then billed to Medicare and Medicaid for payment under Gibson’s billing number.
From January 2007 through January 2012, Gibson caused more than $19.4 million in medical claims to the Medicare and Texas Medicaid Programs. As a result, Medicare deposited approximately $8.5 million into a bank account owned and controlled by Gibson.
Edem operated medical clinics under the names of other individuals to conceal his financial interest in the businesses. Edem and Gibson conspired with one another to cause the submission of false claims to the Medicare and Medicaid programs and share in the proceeds. Gibson and Edem paid patient recruiters for referring Medicare/Medicaid beneficiaries and also paid Medicare beneficiaries for showing up at the medical clinics.
Gibson is set for sentencing on July 1, 2013, at which time he faces up to 10 years in federal prison and a possible $250,000 fine.
Edem also pleaded guilty to the same charge on Feb. 25, 2013. He is scheduled to be sentenced on May 28, 2013.
This case is the result of a joint investigation involving multiple federal and state agencies including agents and investigators of the U.S. Department of Health and Human Services – Office of Inspector General, Railroad Retirement Board, Secret Service, Drug Enforcement Administration, FBI and the Texas Attorney General’s Medicaid Fraud Control Unit. Special Assistant U.S. Attorney Justin Blan and Assistant U.S. Attorney Andrew Leuchtmann are prosecuting this case.