Michelle Turner of Spring, Tex., a patient recruiter for a Houston-area durable medical equipment (DME) business has been convicted of health care fraud connected with an “arthritis kit” fraud scheme. The charges include conspiracy to commit heath care fraud and conspiring to receive illegal kickbacks in exchange for referring Medicare patients.
Turner and others were recruited by Clifford Ubani and Princewill Njoku, owners of Family Healthcare Services, to identify and refer Medicare patients, for which they would receive kickbacks. Family Healthcare then submitted Medicare claims to provide orthotics and other DME to Medicare patients.
Many of the orthotic devices were parts of “arthritis kits,” purportedly being used to treat arthritis-related conditions. The equipment, however, was not medically necessary and/or was not actually provided. Family Healthcare submitted about $1.1 million in false claims to the Medicare program.
Turner set up a calling center, making cold calls to elderly Medicare recipients and offering them free arthritis kits, a practice prohibited by the Medicare rules. Family Healthcare then billed Medicare over $3,000 for the arthritis kits. In fact, the arthritis kits were not medically necessary for the patients, and even if they were necessary, Medicare rules require the beneficiary to pay a 20 percent co-pay for durable medical equipment like the arthritis kits.
At sentencing, Turner faces maximum penalties of 10 years prison time for the health care fraud conspiracy count; five years prison time for conspiring to receive illegal kickbacks; and five years prison time for each count of receiving an illegal kickback for referring a Medicare beneficiary.