A U.S. District Court Judge sentenced two brothers who owned a Houston ambulance company to more than four years in federal prison for convictions of conspiracy to commit healthcare fraud and money laundering, the Department of Justice (DOJ) announced on Monday.
U.S. District Judge Lynn Hughes ordered the brothers to pay more than $2.3 million in restitution and they will serve three years of supervised release at the end of their prison term. Kevin Olufemi Davies, 29, was sentenced to 57 months in prison; his brother Melvin Olusola Davies, 28, was sentenced to 63 months.
The brothers owned and operated KMD Healthcare Services Inc. from their Houston home. They also admitted to transporting Medicare beneficiaries with only one of the two required EMTs and in vans rather than ambulances.
The DOJ has turned up the heat for healthcare fraudsters over the past decade. The Medicare Fraud Strike Force, which is a team effort among the Office of Inspector General, the DOJ, the Offices of the United States Attorneys, the Federal Bureau of Investigation and local law enforcement agencies. These federal officials are looking to stamp out healthcare fraud.
Just over the past month, there have been cases involving a Detroit podiatrist, who was charged in a $13.9 million Medicare fraud case, another Detroit-area physician pleaded guilty in a $17.1 million healthcare fraud case, and a Houston-area home health agency owner pleaded guilty to conspiracy in a $17 million Medicare fraud case.
Since its creation in March 2007, the Medicare Fraud Strike Force has charged nearly 3,000 defendants. The people charged allegedly collectively billed the Medicare program for more than $11 billion, according to the Department of Justice.
These cases should cause alarm for anyone leading a healthcare organization. No one would want their organization named in a case because there weren't the proper checks and balances.
There are ways for hospitals to make sure they are protecting their organizations against this kind of fraud. Venson Wallin, consulting managing director at accounting firm BDO, told Healthcare Dive in 2016 that hospitals should measure and monitor healthcare data in the organization, review compliance programs, and evaluate partners to make sure they perform at the “same level of high expectations.”