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Friday, August 19, 2011

FOUR CONVICTED IN $4.7 MILLION MEDICARE FRAUD

Department of Justice
Office of Public Affairs
The following excerpt is from the Department of Justice website:

Wednesday, August 17, 2011
"WASHINGTON – The owner of a Baton Rouge, La., durable medical equipment (DME) company, a medical doctor and two patient recruiters were each convicted late yesterday for their roles in a $4.7 million Medicare fraud scheme, announced the Department of Justice, the FBI, the Department of Health and Human Services and the Medicaid Fraud Control Unit (MFCU) of the Louisiana State Attorney General’s Office.

After a two-week trial, Nnanta Felix Ngari, Dr. Sofjan Lamid, Henry Lamont Jones and Ernest Payne were each convicted by a federal jury in the Middle District of Louisiana of one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States and to pay and receive illegal health care kickbacks.

Ngari owned and operated Unique Medical Solution Inc., a Baton Rouge-area DME supplier that specialized in the provision of power wheelchairs to Medicare beneficiaries. Evidence at trial established that beginning in late 2003, Ngari paid recruiters, including Jones and Payne, to locate and solicit Medicare beneficiaries to attend “health fairs” hosted by Jones and Payne at churches and other locations. At the health fairs, doctors, including Dr. Lamid, prescribed the beneficiaries power wheelchairs that were medically unnecessary. The prescriptions were used by Ngari to submit false and fraudulent claims, on behalf of Unique, to Medicare. According to information presented at trial, the doctors, including Dr. Lamid, were paid illegal kickbacks by Payne and Jones based on the number of power wheelchair prescriptions generated at the health fairs. Jones and Payne were also paid kickbacks by Ngari on a per prescription basis.

Between 2003 and 2009, Unique submitted approximately $4.7 million in claims to Medicare for purported services. Medicare paid Unique approximately $2.5 million for these claims.

A sentencing date has not yet been scheduled. Both conspiracy counts carry a maximum penalty of 10 years in prison and a $250,000 fine."