Friday, December 11, 2015
Feds file charges against 28 in ‘sprawling health care fraud scheme’ in Dallas area
Federal prosecutors announced Monday they’ve filed criminal charges against 28 people involved in a “complex and sprawling health care fraud scheme” that cost the government $8.7 million.
All 28 have signed documents indicating they would plead guilty, according to the U.S. Attorney’s office in Dallas. Others could still be charged.
“This office will continue to vigorously pursue those who fraudulently obtain benefits at the expense of those who have a legitimate need,” said John Parker, U.S. Attorney for the North District of Texas, in a written statement.
The defendants included doctors and medical providers, independent claims consultants, a senior claims examiner for the federal Department of Labor, and 21 people who said they had injuries preventing them from returning to work. In one case, a Department of Labor senior claims examiner received $24,000 in bribes from a former claims examiner working as a consultant.
Federal officials said the ring fraudulently billed the government for $9.5 million in bogus claims and received $8.7 million. Shutting down the operations will save the government least $11 million in future spending on those defendants’ claims, according to the U.S. Attorney’s office.
Prosecutors said the injured employees included workers at the U.S. Postal Service, Dallas Veterans Affairs Medical Center and other government agencies. They all filed their claims through the Department of Labor’s Office of Worker Compensation Programs. The workers’ tax-free payments were usually 66 to 75 percent of their old salaries. Others received lump-sum payments as high as six figures.
Phillip C. Umphres, attorney for retired postal worker Wanda Proctor, said his client was legitimately injured on the job. But she allowed clinic operator Larry Washington to talk her to into signing paperwork for inflated claims. The government said that many of the workers received $100 for signing forms with false information.
“He can talk an honest person into being dishonest,” Umphres said, referring to Washington as the “bad guy” in this scheme. “And that’s what happened with my client.
Umphres said Proctor, 62, was charged with misdemeanor submission of false claims after receiving a couple of thousand dollars from Washington. He ran Mind Spa in DeSoto and several other businesses specializing in pain management, physical therapy, message and chiropractic services.
“She regretted it almost immediately,” Umphres said. “As soon as the agents came to interview her, she fessed up immediately and apologized…It’s inconsistent with her character.”
Sarah Ann Duncan, attorney for Cassandra Sims, one of the employees on workers compensation, said she expected her client to receive probation. She said Sims, 60, realized she signed documents she should not have but wasn’t in on the scheme.
“I’m not sure she was fully aware of what exactly she was doing,” Duncan said. “She got a little bit of money, but she didn’t know what exactly it was for.”
Mind Spa was raided by federal agents last year and closed. Previously filed documents said Washington claimed he treated 36 patients on a day in 2011 when he was in New York with his daughter.
Attorneys for Washington several others charged in this case could not be reached for comment or declined to comment. Some didn’t have a lawyer listed in the court file.
Dr. Robert Mandell, a licensed psychologist and part owner of AAA Mental Health, filed fraudulent mental health reports that delayed workers from returning to their jobs, according to federal officials. Those mental state certifications were required for employees to return from workers compensation leave, even after they were physically cleared.
AAA Mental Health of Richardson still has a working phone and website, but there was no response to a voicemail seeking comments.
Perry Rowell, a Dallas-based senior claims examiner from the Office of Worker Compensation Programs, received $24,000 in bribes from former examiner Ifeanyi “Tim” Egbuchunam, authorities said.
The two-year investigation was led by the U.S. Postal Service Office of Inspector General and the Department of Labor Office of Inspector General but included help from several other federal agencies.
Here is complete list of those charged:
Willie Atkins, 71, of Lancaster
McArthur Baker, 68, of Dallas
David Banda, 33, of Duncanville
Doris Berry, 52, of Dallas
Byron Bonds, 43, of Mesquite
Michael Bowen, 58, of Dallas
Patricia Brown, 62, of Benbrook
Calandra Cumby, 44, of Dallas
Ifeyani “Tim” Egbuchunam, 60, of Plano
Tonya Evans, 51, of Dallas
Darrell Glasco, 50, of Dallas
Brenda Hall, 65, of Dallas
Regina Howard, 61, of Desoto
Janyce Ingram, 53, of Desoto
Willard Johnson, 64, of Desoto
Dr. Robert Mandell, 72, of Plano
Palante McClain, 47, of Cedar Hill
Vontril McClemore, 61, of Carrollton
Rhonda McCoy, 47, of Arlington
Regina Mitchell, 58, of Dallas
Henrietta Price, 51, of Cedar Hill
Wanda Proctor, 62, of Duncanville
Perry Rowell, 55, of Garland
Rhonda Sanders, 50, of Dallas
Clarinda Scott, 56, of Arlington
Cassandra Sims, 60, of Dallas
Patricia Skinner, 59, of Desoto
Larry Washington, 63, of Desoto
Posted by National SIU