WASHINGTON - The Department of Justice (DOJ) says an investigation by the Medicare Strike Force involving the Department of Health and Human Services (HHS), the FBI and the Louisiana State Attorney General's Office, resulted in two Baton Rouge residents pleading guilty for their role in a $21 million Medicare fraud plot.
Henry Jones, the owner of four durable medical equipment (DME) companies, pleaded guilty before U.S. District Judge James J. Brady in the Middle District of Louisiana to one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States and to pay and receive healthcare kickbacks. Mary Bessie, one of Jones' co-conspirators, pleaded guilty on Jan. 11 to one count of conspiracy to defraud the United States and to pay and receive healthcare kickbacks.
Jones admitted that between 2004 and 2009, he owned and operated four companies that were licensed to supply DME to Medicare beneficiaries. Jones hired people to recruit potential patients who obtained prescriptions for medically unnecessary medical equipment. These "patient recruiters" obtained the patients information and then asked the primary care physicians for prescriptions for orthotic equipment, power wheelchairs, wheelchair accessories and other medical equipment.
When the physicians were unwilling to provide medically unnecessary prescriptions, the patient recruiters asked other physicians to write prescriptions based on cursory examinations of the patients. The recruiters then provided the prescriptions to Jones, who billed them to Medicare and paid the recruiters illegal kickbacks for each prescription obtained.
Bessie admitted that from 2004 to 2009, she solicited and received kickbacks from Jones in return for medically unnecessary prescriptions for Medicare beneficiaries. From 2004 to 2009, Bessie was paid kickbacks, and Bessie aided and abetted the payment of kickbacks in the form of checks totaling $82,230.
The maximum prison sentence for each count of conspiracy to commit health care fraud is 10 years. The maximum prison sentence for each count of conspiracy to defraud the United States and to pay and receive health care kickbacks is five years.