Medicare Fraud Ring|Headed to the Slammer

     HOUSTON (CN) – Two registered nurses were sentenced to 5 years in federal prison for their parts in a $5.2 million Medicare fraud, and two co-conspirators received shorter sentences.



     Mary Ellis, 56, an RN, was sentenced on Valentine’s Day to 63 months in prison and ordered to pay $401,000 in restitution. Ellis was convicted in 2011 of conspiracy to commit health care fraud, conspiracy to pay kickbacks, three counts of receiving illegal kickbacks and two counts of making false statements, the U.S. Attorney’s Office said in a statement.
     Caroline Njoku, 46, also an RN, was sentenced to 63 months in prison and ordered to pay $631,295 in restitution. She was convicted in 2011 of conspiracy to commit health care fraud and conspiracy to pay kickbacks.
     On Monday, co-conspirator Terrie Porter, 48, was sentenced to 2 years in prison and ordered to pay $482,380 in restitution. Porter was convicted last year of conspiracy to receive kickbacks and receiving illegal kickbacks.
     Also on Monday, Florida Holiday Island, 62, was sentenced to 20 days in prison, 5 months of home detention and was ordered to pay $59,739 in restitution. Island pleaded guilty in 2011 to conspiracy to receive kickbacks and receiving illegal kickbacks.
     U.S. District Judge Nancy Atlas sentenced all four of them.
     Family Healthcare Group, a Houston home health care company, paid Ellis, Porter, Island and others to recruit Medicare beneficiaries so it could file claims for skilled nursing that was medically unnecessary or not provided, prosecutors said. Njoku and Ellis falsified documents to support the fraudulent payments, trial evidence showed.
     Prosecutors say that after the Medicare beneficiaries were recruited, other co-conspirators fraudulently signed plans of care stating that the beneficiaries needed home health care though they did not.
     Adelma Casas Sevilla, a registered nurse, was previously sentenced to 18 months in prison, prosecutors said. Sammie Wilson received 3 years of probation after pleading guilty to conspiracy to commit health care fraud.
     Four other defendants await sentencing.

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