Patient Recruiter Sentenced in Detroit for Role in $14.5 Million Medicare Fraud Scheme
WASHINGTON—A patient recruiter who participated in a Medicare fraud scheme that totaled almost $14.5 million was sentenced in Detroit yesterday to serve 86 months in prison.
Acting Assistant Attorney General David A. O’Neil of the Justice Department’s Criminal Division, U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade, Special Agent in Charge Paul M. Abbate of the FBI’s Detroit Field Office, and Special Agent in Charge Lamont Pugh, III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Regional Office made the announcement.
Richard Shannon, 41, was sentenced by U.S. District Judge Denise Page Hood in the Eastern District of Michigan. In addition to his prison term, Shannon was sentenced to serve three years of supervised release and was ordered to pay more than $1.6 million in restitution, jointly and severally with his co-defendants.
On October 26, 2012, Shannon, a patient recruiter for a network of fraudulent home health care companies, was found guilty at trial of one count of conspiracy to commit health care fraud.
According to evidence presented at trial, Shannon and his co-conspirators caused the submission of false and fraudulent claims to Medicare through All American and Patient Choice, two Oak Park-based home health care companies, which purported to provide skilled nursing and physical therapy services to Medicare beneficiaries in the greater Detroit area.
The evidence showed that Shannon acted as a patient recruiter, paying Medicare beneficiaries to sign blank documents for physical therapy services that were never provided and/or medically unnecessary. The owners of Patient Choice and All American then paid physicians to sign referrals and other therapy documents necessary to bill Medicare. Physical therapists and physical therapist assistants would then create fake medical records using the blank, pre-signed forms obtained by Shannon and other patient recruiters to make it appear as if physical therapy services had actually been rendered.
Shannon recruited destitute beneficiaries from housing projects and soup kitchens in the Detroit area, obtaining their patient information in exchange for cash and promises of prescription narcotics prescribed by co-conspirator physicians.
This case was investigated by the FBI, HHS-OIG, and the Internal Revenue Service and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. This case was prosecuted by Deputy Chief Gejaa Gobena, Assistant Chief Catherine Dick and Trial Attorney Niall O’Donnell of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged almost 1,900 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, has removed over 17,000 providers from the Medicare program since 2011.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.