Owner of Houston Health Care Company Pleads Guilty to Defrauding Medicare

WASHINGTON—An owner of a Houston health care company pleaded guilty today in connection with a $654,227 Medicare fraud scheme, announced the Departments of Justice and Health and Human Services (HHS).

Simone Ball, 24, pleaded guilty before U.S. District Judge Lee Rosenthal in Houston to one count of conspiracy to commit health care fraud. In her plea, Ball admitted that she defrauded Medicare of $654,227.

According to court documents, Ball was an owner and operator of Preferred Plus Medical Supply. Preferred Plus maintained a valid Medicare provider number in order to submit Medicare claims for the costs of durable medical equipment (DME) and purported to provide orthotics and other DME to Medicare beneficiaries. According to court documents, Preferred Plus submitted claims to Medicare for DME, including orthotic devices, which were medically unnecessary and/or not provided. Many of the orthotic devices were components of “arthritis kits,” and purported to be for the treatment of arthritis-related conditions, although they were neither medically necessary nor appropriate for such conditions. The arthritis kit generally contained a number of orthotic devices including braces for both sides of the body and related accessories such as heat pads. In total, from August through December 2008, Preferred Plus submitted approximately $654,227 in fraudulent claims to Medicare.

At sentencing, scheduled for Oct. 12, 2011, Ball faces a maximum sentence of 10 years in prison.

Today’s guilty plea was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney José Angel Moreno of the Southern District of Texas; the Texas Attorney General Greg Abbott; Acting Special Agent-in-Charge Russell D. Robinson of the FBI’s Houston Field Office; and Special Agent-in-Charge Mike Fields of the Dallas Regional Office of HHS Office of Inspector General (HHS-OIG), Office of Investigations.

This case is being prosecuted by Trial Attorneys Laura M.K. Cordova and Benjamin O’Neil, and Deputy Chief Charles La Bella of the Criminal Division’s Fraud Section. The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section.

Since their inception in March 2007, Medicare Fraud Strike Force operations in nine districts have obtained indictments of more than 1,000 individuals who collectively have falsely billed the Medicare program for more than $2.3 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are 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.