Six Texans Get Prison for Medicare Fraud

     (CN) – Six Houston residents who defrauded Medicare and Medicaid of $17.6 million were sentenced to years in federal prison and ordered to pay millions of dollars in restitution.
     James Reese, 56, was sentenced to 15 years and ordered to pay $8.6 million in restitution and $477,000 in taxes.
     Lia St. Junius, 26, was sentenced to 11 years and 3 months in prison and ordered to pay $8.6 million in restitution.
     Brenda Lopez, 35, was sentenced to 43 months in prison and ordered to pay $8.6 million in restitution. When she gets out of prison, Lopez will be deported.
     Devon Michel Spicer, 49, was sentenced to 5 years in prison and ordered to pay $750,000 in restitution and fined $71,000.
     Martha B. Ramos, 58, was sentenced to 5 years in prison, ordered to pay $53,000 in restitution and fined $4,100. The judge ordered that her green card be revoked and she be deported when she gets out of prison.
     Lily Zathel Johnson, 38, was sentenced to 33 months and ordered to pay $4 million in restitution.
     U.S. District Judge David Hittner barred all six defendants from seeking employment in any field that bills Medicare or Medicaid.
     They were charged in a 47-count indictment in October 2010 with conspiracy to commit health care fraud, health care fraud, paying or receiving kickbacks, money laundering and tax evasion.
     Reese, Lopez and Johnson pleaded guilty; St. Junius, Spicer and Ramos were convicted at trial this year.
     Reese owned a durable medical equipment company, The Mobility Store. He and his daughter, St. Junius, lied to Medicare and Medicaid that St. Junius was sole owner of the business, because Reese was a felon and could not participate as a provider in Medicare and Medicaid programs. They defrauded Medicare and Medicaid by by submitting fraudulent claims for orthotic braces and devices, which they called “The Artho Kit.”
     St. Junius paid marketers 10 percent of the amount received from Medicare for each orthotic brace or device billed. She was convicted of conspiracy to commit health care fraud, seven counts of substantive health care fraud and conspiracy to commit money laundering.
     Spicer was convicted on all substantive counts of receiving kickbacks. Evidence showed Medicare paid $750,000 to beneficiaries he referred to The Mobility Store in 2005. Spicer got about $71,000 from the deal.
     Ramos was found guilty on all substantive counts of receiving kickbacks. Evidence showed The Mobility Store was paid $53,000 for beneficiaries she referred, and Ramos got about $4,000 from it.
     Lopez and Johnson, who managed marketers and billing, pleaded guilty to conspiring to commit health care fraud, and testified against the other defendants at trial.
     Medicare revoked The Mobility Store’s provider number in 2008. The Mobility Store billed Medicare and Medicaid for more than $17.6 million and was paid more than $8.6 million.
     Trial testimony revealed that St. Junius bought several cars and a $650,000 home with money from the fraud.
     St. Junius, Spicer, Ramos, Reese and Lopez are in custody. Johnson is to surrender at a date to be determined.

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