Mastermind of $56 Million Medicare Fraud Scheme and Doctor Plead Guilty
WASHINGTON—The organizer of a $56 million Medicare fraud conspiracy and an accomplice physician pleaded guilty today in federal court in Louisiana to health care fraud charges.
Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Kenneth A. Polite of the Eastern District of Louisiana, Special Agent in Charge Michael Anderson of the FBI’s New Orleans Field Office, Special Agent in Charge Mike Fields of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Regional Office and Louisiana Attorney General James D. “Buddy” Caldwell made the announcement.
Mark Morad, 51, of Slidell, Louisiana, and Dr. Divini Luccioni, 53, of Kenner, Louisiana, each pleaded guilty before Chief U.S. District Judge Sarah S. Vance of the Eastern District of Louisiana today. Morad pleaded guilty to conspiracy to commit health care fraud and conspiracy to falsify records in a federal investigation. Dr. Luccioni pleaded guilty to conspiracy to commit health care fraud. Sentencing hearings for each are scheduled for April 1, 2015.
According to court documents, Morad directed a Medicare fraud scheme through multiple New Orleans-area companies he owned, including Interlink Health Care Services Inc., Memorial Home Health Inc., Lakeland Health Care Services Inc., Lexmark Health Care LLC, and Med Rite Pharmacy Inc. Morad controlled all aspects of these companies, from hiring to deciding what services would be billed. The companies claimed to provide home health services and durable medical equipment (DME) to thousands of Medicare beneficiaries living in and around New Orleans.
Morad paid kickbacks to recruiters who canvassed New Orleans neighborhoods for Medicare beneficiary numbers, which Morad then used to bill Medicare for services that were not medically necessary or not provided. Dr. Luccioni admitted that he signed home health referrals and wrote DME prescriptions that were used to support these fraudulent billings. Specifically, court documents show that Dr. Luccioni falsely certified that beneficiaries were homebound and qualified for home health services, and that he wrote prescriptions for power scooters and other DME that he knew the purported beneficiaries did not need.
When a federal grand jury subpoenaed records from another company Morad owned, he and others fabricated tax and employment records to conceal the companies’ illegal activities and mislead the grand jury.
Medicare billing records showed that between 2007 and 2014, Morad’s companies submitted more than $56 million in claims to Medicare, a vast majority of which were fraudulent. Medicare paid approximately $50.7 million on these claims.
This case was investigated by the FBI, HHS-OIG and the Louisiana Attorney General’s Medicaid Fraud Control Unit, 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 Louisiana. This case was prosecuted by William G. Kanellis of the Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is 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.