Six Louisiana Individuals Found Guilty of Medicaid Health Care Fraud 

Acting U.S. Attorney Duane A. Evans announced that on May 9th, after over four weeks of trial, a federal jury returned guilty verdicts against six individuals charged with committing approximately $13,655,094 in Medicare fraud.

Specifically, HENRY EVANS, age 71, was found guilty of five counts of health care fraud; MICHAEL JONES, age 47; PAULA JONES, age 45; SHELTON BARNES, age 62; GREGORY MOLDEN, age 60, all of New Orleans; and JONATHON NORA, age 29, of River Ridge, were all found guilty of conspiracies to commit health care fraud and to defraud the United States and to receive and pay health care kickbacks, and health care fraud. BARNES, MICHAEL JONES, MOLDEN, and NORA were also found guilty of individual counts of health care fraud. Additionally, BARNES was found guilty of obstruction of a federal audit.

The Second Superseding Indictment is related to the Indictment returned in March 2015 charging Lisa Crinel and others with health care fraud. Nineteen individuals and/or companies pleaded guilty before trial to charges associated with the original Indictment.

According to the Second Superseding Indictment, the defendants participated in a criminal organization for the purpose of fraudulently billing Medicare for medically unnecessary home health services for patients who were not homebound. DRS. BARNES, EVANS, MOLDEN and MICHAEL JONES, known as “House Doctors,” ordered home health services for Medicare beneficiaries who had no legitimate medical necessity. The House Doctors falsely signed home health orders regardless of the beneficiaries’ needs, homebound status, or diagnoses. In return, DRS. BARNES, EVANS, and MOLDEN received monthly payments fraudulently characterized as medical consultant or director fees for which they provided no services other than fraudulently certifying Medicare beneficiaries for unnecessary home health services. Instead of receiving monthly payments from the home health agency, Abide hired PAULA JONES, DR. MICHAEL JONES’ wife and, thereafter, inflated salary payments to PAULA JONES in order to pay MICHAEL JONES’ fees for fraudulently certifying home health for ineligible Medicare beneficiaries.

Marketers contacted JONATHON NORA and others to confirm that the person fraudulently referred for home health was a Medicare beneficiary. Once NORA determined that the referred individual was a Medicare beneficiary, NORA scheduled a physician visit, usually with an Abide House Doctor, well knowing that the individual referral to Abide was by a Marketer, instead of the beneficiary’s own health care professional.

Abide generated plans of care reflecting the falsely created assessments. The plans of care were given to DRS. BARNES, EVANS, MOLDEN, and MICHAEL JONES to falsely certify and recertify medically unnecessary episodes of home health. PAULA JONES fraudulently billed Medicare, on behalf of Abide,for the medically unnecessary home health services.

The Superseding Indictment also charged SHELTON BARNES with obstruction of a federal audit in connection with him billing Medicare Part B for services related to the medically unnecessary home health services.

DR. SHELTON BARNES faces a possible maximum sentence of 170 years imprisonment, DR. HENRY EVANS faces a possible maximum sentence of 50 years, DR. GREGORY MOLDEN faces a possible maximum sentence of 115 years, and DR. MICHAEL JONES faces a possible maximum sentence of 95 years. Additionally, JONATHON NORA faces a possible maximum sentence of 25 years and PAULA JONES faces a possible maximum sentence of 15 years. Defendants are also subject to a maximum $250,000 fine for each count of conviction.

Acting U.S. Attorney Evans praised the work of the Special Agents of the Federal Bureau of Investigation and the United States Department of Health and Human Services, Office of Inspector General in investigating this matter. Assistant U.S. Attorneys Patrice Harris Sullivan, Hayden Brockett, Maria Carboni, and Sharan Lieberman prosecuted the case.

Source: Six Individuals Found Guilty of Health Care Fraud | USAO-EDLA | Department of Justice

One Response

  • Seem like now finally they are hitting the jackpot.

    Finally Dentist are not fraud target any longer.

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