Local Ambulance Company Supervisor Pleads Guilty in Health Care Fraud Case
Defendant Fraudulently Billed Government More Than $1.57 Million for Transferring Patients to Scheduled Dialysis Appointments
|U.S. Attorney’s Office March 25, 2010|
DALLAS—A former high-level employee of Royal and First Choice ambulance services, Shaun Outen, 32, of Aubrey, Texas, pleaded guilty yesterday in federal court to one count of conspiracy to commit health care fraud, announced U.S. Attorney James T. Jacks of the Northern District of Texas. Outen faces s a maximum statutory sentence of five years in prison, a $250,000 fine and restitution. Sentencing is set for June 16, 2010, before U.S. District Judge Jorge A. Solis.
According to filed documents, Outen worked as an emergency medical technician, supervisor, and director of operations during parts of 2004, 2005 and 2006 for Royal Ambulance Services, Inc. and First Choice EMS, Inc. Both companies were controlled and operated by co-defendant Muhammed Nasiru Usman, 50, of Arlington, Texas. When in business, Royal had offices in Dallas and DeSoto, Texas. First Choice EMS, Inc. was previously located in Carrollton, Texas.
Royal and First Choice primarily transferred patients on a non-emergency basis to and from dialysis treatments three times per week. As part of his guilty plea, Outen admitted conspiring with co-defendants Usman and David McNac, 35, of Dallas to defraud Medicare, Medicaid and the Federal Employee Health Benefits Program by submitting fraudulent claims related to the transportation of dialysis patients. Outen also admitted that he and his co-defendants told Royal and First Choice employees to omit facts when documenting their transports of Royal and First Choice patients, such as whether the patients walked to the ambulance, in order to qualify the transports for reimbursement. Additionally, many of the companies’ records revealed that patients simply rode to their appointments in a captain’s chair in the back of the ambulance rather than lying on a stretcher.
Usman and McNac were responsible for the submission of more than $1.57 million in fraudulent claims to Medicare and Medicaid through Royal Ambulance and First Choice EMS, resulting in payments of more than $500,000. Both are charged with conspiracy to commit health care fraud and 12 counts of health care fraud and aiding and abetting. In addition, Usman is charged with one count of money laundering and McNac is charged with two counts of tampering with a witness by harassment. Both men are scheduled for trial before Judge Solis on April 26, 2010.
The case is being investigated by the U.S. Department of Health and Human Services - Office of Inspector General, IRS - Criminal Investigation, U.S. Office of Personnel Management, Texas Attorney General Greg Abbott’s Office - Medicaid Fraud Control Unit, and the FBI. Assistant U.S. Attorney Katherine Miller and Special Assistant U.S. Attorney Michael McCarthy are prosecuting the case.