Four Convicted in $4.7 Million Louisiana Medicare Fraud Scheme

WASHINGTON—The owner of a Baton Rouge, La., durable medical equipment (DME) company, a medical doctor, and two patient recruiters were each convicted late yesterday for their roles in a $4.7 million Medicare fraud scheme, announced the Department of Justice, the FBI, the Department of Health and Human Services and the Medicaid Fraud Control Unit (MFCU) of the Louisiana State Attorney General’s Office.

After a two-week trial, Nnanta Felix Ngari, Dr. Sofjan Lamid, Henry Lamont Jones, and Ernest Payne were each convicted by a federal jury in the Middle District of Louisiana of one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States and to pay and receive illegal health care kickbacks.

Ngari owned and operated Unique Medical Solution Inc., a Baton Rouge-area DME supplier that specialized in the provision of power wheelchairs to Medicare beneficiaries. Evidence at trial established that beginning in late 2003, Ngari paid recruiters, including Jones and Payne, to locate and solicit Medicare beneficiaries to attend “health fairs” hosted by Jones and Payne at churches and other locations. At the health fairs, doctors, including Dr. Lamid, prescribed the beneficiaries power wheelchairs that were medically unnecessary. The prescriptions were used by Ngari to submit false and fraudulent claims, on behalf of Unique, to Medicare. According to information presented at trial, the doctors, including Dr. Lamid, were paid illegal kickbacks by Payne and Jones based on the number of power wheelchair prescriptions generated at the health fairs. Jones and Payne were also paid kickbacks by Ngari on a per prescription basis.

Between 2003 and 2009, Unique submitted approximately $4.7 million in claims to Medicare for purported services. Medicare paid Unique approximately $2.5 million for these claims.

A sentencing date has not yet been scheduled. Both conspiracy counts carry a maximum penalty of 10 years in prison and a $250,000 fine.

The verdicts were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Donald J. Cazayoux Jr. of the Middle District of Louisiana; Mike Fields, Special Agent in Charge of HHS-Office of Inspector General (OIG) Dallas regional office; David Welker, Special Agent in Charge of the FBI’s New Orleans Division; and Louisiana State Attorney General James Buddy Caldwell.

The case was prosecuted by Trial Attorneys Ben Curtis and David Maria of the Criminal Division’s Fraud Section. The case was investigated by the FBI, HHS-OIG, and MFCU of the Louisiana State Attorney General’s Office. The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Middle District of Louisiana.

Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,000 defendants that collectively have 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.