$22 Million Scam Provided Zilch, Feds Say

     DALLAS (CN) – A Dallas attorney and two relatives defrauded a workers’ compensation program of $22 million by submitting hundreds of phony bills, federal prosecutors claim.
     Tshombe Anderson, 52, was arrested Friday in Dallas. His wife, Brenda Anderson, 45, was arrested in Dallas on Wednesday, as was his sister, Lydia Bankhead, 61, in Russellville, Ark. All are charged with mail fraud and two counts of health care fraud and theft of government funds.
     Every single bill sent by at least two of their companies was fraudulent, prosecutors said.
     Mail fraud is punishable by up to 10 years in federal prison and a $250,000 fine and health care fraud and theft of government funds by up to 20 years and a $250,000 fine on each count.
     The criminal complaint, filed under seal on Aug. 25, claims Tshombe Anderson formed at least three durable medical equipment companies to provide unwanted and unrequested medical equipment for rehab patients. He worked as an attorney for Austin-based Union Treatment Center from February 2010 to May 2011. That company is not a party to the criminal complaint.
     “In February 2010, Brenda Anderson also began working for Union, and shortly thereafter, she formed Best First Administration Durable Medical Equipment of Austin, which became Union’s ‘in-house’ DME provider,” prosecutors said in a statement, “In general, according to the complaint, a Union doctor would provide Brenda Anderson with a prescription for a patient’s DME items, and she would then send the prescribed DME to the patient.”
     Union fired the Andersons in May 2011 after an audit revealed “they appeared to be engaging in fraudulent billing practices,” the complaint states.
     Union then created its own in-house DME company, but Brenda Anderson and her company “retained patient records and identifying information and used that information to continue to bill” for unrequested and unnecessary DME equipment for Union’s patients, prosecutors said.
     “In January 2013, Tshombe Anderson formed Union Medical Supplies & Equipment, LLC, which records indicate was managed by Lydia Bankhead and their mother,” prosecutors said. “In April 2013, USME began fraudulently billing [Dept. of Labor, Office of Workers’ Compensation Programs] for DME delivered to the same Union patients as BFA. In January 2014, USME changed its address with OWCP from 327 Cedar Creek Drive in Duncanville, Texas, to 2606 Martin Luther King Jr. Blvd., in Dallas, an address located next door to The Law Office of Tshombe A. Anderson, LLC, located at 2604 Martin Luther King Jr. Blvd., in Dallas. Every DME transaction billed by UMSE since its formation appears to be fraudulent.”
     Three months later, Tshombe Anderson formed Sky-Care Medical Supplies and Equipment, LLC, and listed his sister-in-law as manager, the complaint states.
     “In August 2013, SMSE began billing OWCP for the same patients as BFA and UMSE,” prosecutors said. “Every DME transaction billed by SMSE since its formation appears to be fraudulent.
     At least 292 patient claim numbers were filled by one of the Anderson’s companies from January 2011 to April 9, 2015, according to the complaint.
     “From April 11, 2013 through April 9, 2015, USME billed approximately $22,498,085 and was paid $19,573,704 by OWCP for DME that was not needed or requested by the patient or the doctor treating the patient,” prosecutors said. “From August 7, 2013 through April 9, 2015, SMSE billed approximately $1,833,895 and was paid $1,706,848 by OWCP for DME that was not needed or requested by the patient or the doctor treating the patient.”
     Anderson’s office did not respond to a request for comment Saturday.

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