FBI — DME Owner Heads to Prison for Multiple Counts of Health Care Fraud

HOUSTON—Andrea Michelle Tellison, 47, has been ordered to federal prison for eight years following her convictions of 14 counts of health care fraud and seven counts of aggravated identity theft, announced United States Attorney Kenneth Magidson. A jury convicted Tellison April 2, 2014, following three days of trial and less than two hours of deliberation.

Today, U.S. District Judge Lee Rosenthal, who presided over the trial, handed Tellison a sentence of 72 months for the health care fraud convictions. She was further ordered to serve a mandatory two years for the aggravated identity theft charges which must be served consecutive to the health care fraud term imposed, resulting in a total sentence of 96 months in federal prison.

At the hearing today, the United States presented testimony from a representative of United Health Care who paid $7,732.99 on fraudulent claims for tube feeding nutrition and tube feeding supplies. An FBI financial analyst also testified about how the Tellison’s scheme also encompassed various orthotic braces, such as elbow, shoulder and back braces as well as incontinence products. In handing down the sentence, Judge Rosenthal considered the scope of the health care fraud, the importance of programs such as Medicare and Medicaid, along with the Tellison’s history and character in arriving at the sentence. Following her sentence, Tellison will be on supervised release for three years. The court also imposed a personal money judgment in the amount of restitution—$1,217,936.70.

Telliso was the director of operations, chief compliance officer and co-owner of Texas Durable Medical Company. She was charged in March 2013 with health care fraud and aggravated identity theft in relation to the submission of false and fraudulent durable medical equipment claims, including more than $1.48 million worth of tube feeding nutrition and tube feeding supply claims.

During trial, jurors heard the testimony of six Medicare beneficiaries detailing that they did not need tube feedings and did not receive tube feeding supplies despite Tellison billing thousands of dollars for those items. They also heard from seven Houston area physicians who stated they did not order tube feedings or tube feeding supplies for the Medicare beneficiaries and that they did not authorize Tellison to use their names and UPIN numbers to submit claims to Medicare and Medicaid for those items.

Special agents from the Railroad Retirement Board (RRB) and the FBI testified that in a 2011 interview, Tellison admitted both knowledge of the false and fraudulent claims and the insufficient inventory for delivery to Medicare beneficiaries. A forensic accountant from the FBI further testified that Tellison not only failed to purchase the 29,113 tube feeding supply kits, but that she also failed to purchase sufficient quantities of nutritional products for delivery. Various representatives from Medicare and Medicaid contractors provided supporting testimony about how these federally funded programs operate and the claims submitted by Tellison. The government also presented evidence including many forms that had been signed by Tellison indicating that Medicare beneficiaries needed tube feedings and tube feeding supplies when they did not, and that Tellison did not order those items for delivery.

Today, the court also heard how the defendant’s scheme included various braces and incontinence products she also did not purchase for delivery.

Tellison was permitted to remain on bond and voluntarily surrender to a U.S. Bureau of Prisons facility to be determined in the near future.

The investigation into Tellison was the result of a joint investigation conducted by agents from the FBI, RRB—Office of the Inspector General, Department of Health and Human Services—Office of Inspector General and the Texas Attorney General’s Office Medicaid Fraud Control Unit. Assistant United States Attorneys Julie Redlinger and Tina Ansari prosecuted the case.

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