Colossal Medicare Fraud Arrest

This one is really sick:
The owner of a Frisco-based hospice company, his wife and 14 others have been indicted in a $60 million Medicare fraud scheme that put financial interests over the needs of patients, according to the U.S. attorney's office for the Northern District of Texas.
Some patients died of overdoses at the hands of nurses, according to the indictment, which was unsealed Tuesday and includes charges of health-care fraud and conspiracy to commit health-care fraud.
Those charged include Bradley J. Harris, 35, of Frisco, who owned and operated Novus Health Services and Optim Health Services Inc., and his wife, 42-year-old Amy Harris, who co-founded Novus and worked as vice president of patient services. Five of the defendants are doctors. Five are nurses.
The for-profit Novus Health Services is one of the largest hospice providers in North Texas.

The company did not respond to a request for comment. The defendants and most of their attorneys could not immediately be reached.
Attorney Mike Uhl is representing Samuel D. Anderson, 35, who co-founded Novus and worked as a vice president of marketing. Anderson was indicted on one count of conspiracy to commit health-care fraud.
"Sam and I will review the charges and whatever evidence the government has and then make a decision about the appropriate next steps," Uhl said by email. "At this point, he enjoys the presumption of innocence guaranteed all citizens."
The office for Novus Health Services was housed in this building in Frisco in 2015.
The office for Novus Health Services was housed in this building in Frisco in 2015.
Among the accusations are that medical directors certified that patients were eligible for hospice care whether they were or not, according to authorities. Hospice care provides support to patients with terminal illnesses and their families.
Harris would place patients on continuous care — which Medicare paid at a higher daily rate than routine care— whether those patients needed it or not. In 2013, Medicare paid a daily rate of $153 for routine hospice services compared with the daily rates for continuous care that ranged from $303 to $895, according to the indictment.
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Nurses gave high doses of drugs such as morphine, regardless of whether patients needed it, to justify the higher payments, prosecutors said. In some instances, these excessive dosages resulted in serious bodily injury or death.
"That these defendants used human life at its most vulnerable stage as the grist for this scheme displays a shocking level of depravity that this community simply cannot tolerate," U.S. Attorney John Parker said in a news release Tuesday.
The case against Novus
The indictment alleges that from July 2012 to September 2015, Novus billed Medicare and Medicaid more than $60 million for fraudulent hospice services. The government paid Novus more than $35 million.
The defendants are accused of submitting false claims for hospice services, submitting false claims for continuous care hospice services, recruiting ineligible hospice beneficiaries by providing kickbacks to referring physicians and health care facilities, and falsifying and destroying documents to conceal these activities from Medicare, federal officials say.
Last March, when news of the federal investigation became public, Novus posted a statement online, saying, "We have not and would not — ever — willfully harm any patient."

In addition to the Harrises and Anderson, indictments were issued for Melanie L. Murphey, 35, of Fort Worth, who was Novus' director of operations; Patricia B. Armstrong, 33, of Coppell, who was a registered nurse and primary triage nurse for after-hours patients; Jessica J. Love, 37, of Gainesville, who worked as a registered nurse and a district manager; Ali Rizvi, 49, of Carrollton, who owned a separate physicians' home visit company; Tammie L. Little, 55, of Brashear, who worked as a registered nurse and district manager; Mary Jaclyn Pannell, 29, of Krum, who worked as Novus' director of nursing; Taryn E. Stuart, 32, of Sanger, who worked as a licensed vocational nurse; and Slade C. Brown, 47, of Plano, who worked as a director of marketing.
Five licensed physicians who worked as medical directors for Novus were also indicted. They are Mark E. Gibbs, 46, of Lindsay; Syed M. Aziz, 51, of Frisco; Reziuddin Siddique, 63, of Allen; Charles R. Leach, 64, of Arlington, and Laila N. Hirjee, 50, of Plano;
A woman who answered the phone at Hirjee's office said, "We can't give you any comment at this time."
As part of the scheme, physicians and assisted living facilities were offered salaries or other forms of payment in exchange for patient referrals to Novus hospice care, the indictment stated. It quoted an email from Leach that stated in part: "My goal was to send as much business to Brad and Amy in return for directorships, etc."
But doctors had little oversight of patients. Instead, care was directed primarily by nurses and by Harris, a certified public accountant who didn't hold any medical licenses, authorities said.
According to the indictment, Gibbs or Hirjee would state that they had met personally with patients before they were recertified for hospice even though such encounters would not have been possible. In one instance, Gibbs signed 19 face-to-face evaluations on July 18, 2013, that would have required him to have traveled about 200 miles to 19 different locations before 1:30 p.m. In another example cited by the indictment, Hirjee dated recertification visits in Texas on dates when she was in Hawaii or Mexico.
Around May 2013, the indictment alleges Bradley Harris texted Taryn Stuart to take over one patient's care. "I told this chick if she would just give her 1 ml of Ativan and turn her she would die," the indictment alleges Harris wrote.
Harris sent another text, saying, "[expletive] woman is still alive ... I need some boots on the ground."
Stuart stayed in contact with Harris, while she gave medicine to the patient. The indictment stated he then sent a text about the need to medicate in order to justify continuous care: "We have very strict guidelines that we must be providing skilled nursing interventions at least ever hour to stay in there."
After the patient died, Stuart texted Harris, and he responded, "Nice work."
The case is being investigated by the FBI, the U.S. Department of Health and Human Services office of inspector general and the Texas attorney general's Medicaid Fraud Control Unit.
Federal officials are seeking forfeiture of any property derived from the offenses alleged in the indictment. The document notes that more than $103,000 has already been seized from Bradley Harris.
Read the full indictment, which was unsealed on Feb. 28, 2017:
Federal indictment in $60 million Medicare fraud scheme by The Dallas Morning News on Scribd

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