Owner of Durable Medical Equipment Company Pleads Guilty to Medicare Fraud

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On Friday, Chikenna D. Jones, the thirty-six year old owner of several Louisiana based durable medical equipment companies, plead guilty to conspiracy to defraud the United States and conspiracy to commit health care fraud.

She faces up to fifteen years in prison for her part in this Medicare Scam, which resulted, according to court records, in around $20 million in fraudulent Medicare Claims.

Jones, as per court records, admitted responsibility for fraudulently billing Medicare for Durable Medical Equipment from 2004 until 2009, allegedly paying patient recruiters kickbacks for providing Medicare patents that could be billed for unneeded medical equipment.

Allegedly, Henry Jones, who was her husband during this period, used information provided by patient recruiters, to bill Medicare for electric wheelchairs, arm and leg braces, and other types of durable medical equipment that require a doctors prescription.

As part of her plea agreement, Jones admitted that she was aware that the durable medical equipment was not required by the patients.

Jones is listed as the owner of a number of health care companies in Louisiana, including Medical 1 Patient Services LLC, Healthcare 1 LLC, Rose Medical Inc., and Lifeline Healthcare Services Inc.

According to public records, Medical 1 Patient Services LLC was founded in 2007 and Healthcare 1 LLC was founded in 2003. Both are related to Aldebaran Management Company, LLC.

Lifeline Healthcare Services was founded in 2004 and the chief operator is Chikenna Jones ex-husband, Henry Jones. The last reported filing for this company was in 2007.

Aldebaran Management Company is based out of Las Vegas Nevada and has a revoked business license, as per Nevada Public Records. It’s registered agent is another company, ACORN CORPORATE SERVICES, which was founded in 1993 and uses the same business address. Rose Medical LLC was listed as the business name of two companies in Nevada, however neither are tied directly to the other companies.

Extensive Business History in Louisiana

According to Louisiana public records, Chikenna D. Jones, Henry L. Jones, and Aldebaran Management Company have ties to a number of very diverse businesses, dating back to at least 2005.

This includes non-profits like Paris In the Spring Education Group and The Lifeline Ministry INC, and , as well as the Non-Profit Religious Corporation, Christian Fellowship Church Ministries, INC.

Other Registered Businesses Include:

  • Mindscape Learning Institute Inc
  • We Shoot First LLC
  • Shoe Laces LLC
  • Cancer Funding Group Inc
  • Homecare Cleaning Services LLC
  • Zoe Equipment Corporation INC
  • Darius’ Freight and Shipping LLC
  • Jairus’ Consulting and Property Management LLC
  • Global Wealth Management Group LLC

Based off the names of the businesses, the numerous business listings indicate that the Jones were involved in many different and diverse industries, including transportation, marketing, film-making, education, cancer research, education, religion, and more. These businesses were, for the most part, registered in Prairieville, Zachary, and Baton Rouge Louisiana.

Another Sentenced in American Therapeutic Corporation Kickback Scheme

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This week, Natalie Evans, who is the fifty year old owner of a halfway houses located in Fort Lauderdale Florida, was sentenced to 28 months in prison after pleading guilty to a single count of conspiracy to commit health care fraud. She was also ordered to pay a fine of around $250,000 and will serve 3 years of probation after release. She is the most recent in a string of convictions against those involved with the American Therapeutic Corporation(ATC) Medicare kickback scheme.

Evans is listed as the President of Vision of Hope Recovery, Inc, which was established in 2008 and is listed as a non-profit corporation in Florida. Together with the Vice President, Harvey Dixon, Evans ran five halfway houses in the Fort Lauderdale area. Most of Evans patients were recovering drug and substance abuse addicts.

According to her plea deal, Evans admitted to providing Medicare patients to American Therapeutic Corporation and American Sleep Institute(ASI), for a mental health treatment called a partial hospitalization program, or PHP. In return for providing Medicare recipients, Evans received kickbacks for each day the patient received treatment.

As per court records, Evans admitted that the patients did not need this type of treatment and that she was aware that ATC and ASI routinely billed Medicare for fraudulent treatments. She admitted to being responsible for over a half-million in fraudulent Medicare billings.

The investigation into American Therapeutic Corporation(ATC) and American Sleep Institute(ASI,) which are owned by Medlink Professional Management Group Inc, is ongoing. It is presumed to be one of the biggest Medicare fraud cases to date, responsible for over $200 million in fraudulent Medicare Billing and involving a number of owners, operators, and patient recruiters in the Florida area.

Detroit Patient Recruiter Sentenced to 30 Months

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Last week, Santiago Villa-Restrepo, who plead guilty to conspiracy to commit health care fraud in November 2011, was sentenced to 30 months in Prison and has been ordered to repay nearly $3 million, with the assistance of his co-defendants.

Villa-Restrepo plead guilty to providing kickbacks to Medicare recipients who took part in medical tests at several Detroit based medical clinics. Medicare recipients allegedly signed forms stating they had undertaken treatment from these clinics and, in return, received case from Villa-Restrepo and his co-defendants.

The owners of these clinics are also charged, were allegedly complicit in this crime, which resulted in around five and a half million dollars in Medicare fraud. While Villa-Restrepo was not convicted until November 2011, the Medicare fraud dated back to 2007.

Villa-Restrepo faced up to 10 years in prison when he was originally convicted.

Five Plead Guilty in Michigan Medicare Scam

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Last week, Maira Suleman and three other individuals plead guilty to a single count of conspiracy to commit health care fraud, as the result of their part in an alleged Medicare Fraud Scheme related to two home medical companies. Another man, Gerald Funderburg, also plead guilty in an unrelated Medicare Fraud case.

Suleman, Curtis Mallory, Theodore Haile, and John Thomas are scheduled to be sentenced on April 19, 2012 and each face up to ten years in prison and up to a quarter of a million in fines.

According to the plea agreement, the defendants Mallory, Suleman, and Haile were complicit in Medicare Fraud at All American Home Care Inc. and Patient Choice Home Care Inc.

All American Home Care and Patient Choice Home Care were incorporated, according to Michigan’s business database, in 2005 and 2007 respectively. They are involved with home health care.

As part of the plea agreement, Mallory and Haile stated they paid kickback to Medicare recipients, as part of their jobs as patient recruiters for these companies. In turn, the Medicare recipients information was used to submit fraudulent claims to Medicare for physical therapy that was either not preformed or was not medically required.

John Thomas admitted to creating false physical therapy documentation as part of his job as a physical therapist for both companies. This documentation was used to bill Medicare.

Maira Suleman is listed in the Articles of Incorporation for Patient Choice Home Care Inc. and stated in court that she was the office manager at this company. Another man, Hassan Akhtar, has ties to both companies, according to public business records.

Suleman admitted to helping facilitate the Medicare fraud by coordinating the collection and documentation of fabricated therapy forms, as well as preforming the actual submission of claims to Medicare for payment.

In the separate case, Gerald Funderburg admitted responsibility for illegally using information from around 500 different Medicare recipients, without their knowledge, in order to submit claims for mental health services that were not preformed in most cases.

Funderburg is listed as the sole owner of Funderburg Clinical and Community Services Inc( FCCS,) which was incorporated in 2006.

According to his plea agreement, admitted to submitting close to 5,000 fraudulent claims that were related to over $3 million billed to Medicare.

Funderburg is scheduled to be sentenced on June 8, 2012 and also faces up to ten years in prison and a $250,000 fine.

Another Guilty Plea in Miami American Therapeutic Corporation Medicare Scam

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Sandra Jimenez, who is 38 years old and from Miami, plead guilty yesterday as part of the ongoing American Therapeutic Corporation, or ATC, Medicare Fraud Scheme. She plead guilty to a single count of conspiracy to commit health care fraud and, according to the Department of Justice, was responsible for around $45 million in fraudulent Medicare claims.

As part of Jimenez’s guilty plea, she admitted responsibility for providing kickbacks to assisted living facility owners who provided, typically, unqualified patients for American Therapeutic Corporation’s(ATC) and the American Sleep Institutes'(ASI) partial hospitalization programs, or PHPs.

Jimenez’s worked as a Marketer for these companies, which according to her court statements, entailed locating business owners and those who worked at half-way houses or assisted living facilities, who would be able to refer Medicare patients to her employers partial hospitalization programs. The owners received kickbacks for each day their referred patients stayed in the PHP, which Jimenez has admitted to arranging.

In addition to her work with ATC and ASI, Jimenez also, as part of her guilty plea, admitted to a separate Medicare fraud scheme she was involved with, related to Priority Home Health. In this scheme, Jimenez and others that worked with the Miami based home medical agency, actively recruited Medicare recipients to their company who were not eligible to receive services from the company.

Jimenez sentencing is scheduled for the end of June, June 27, 2012, where should could face up to fifteen years in prison and up to a quarter of a million in fines.

The American Therapeutic Corporation and American Sleep Institute Medicare fraud scam is one of the largest in the company and relied on a large network of doctors, recruiters, and even Medicare recipients, who provided mostly ineligible Medicare patients to receive mental health services. These services would not qualify as partial hospitalization programs and were responsible for more than $200 million in Medicare fraud.

Many defendants have already been tried and convicted in Federal court for their part in this scam, with other trials set for the following months.

The defendants include a wide range of individuals, including those from the parent company, Medlink Professional Management Group Inc.