DALLAS (WBAP/KLIF)- The Department of Justice announces a health care fraud enforcement operation across the state of Texas.
58 people were charged for their alleged involvement in medical fraud schemes and networks of “pill mill” clinics resulting in $66 million in loss and 6.2 million pills. Of those charged, 16 were doctors or medical professionals, and 20 were charged for their role in diverting opioids.
Enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division’s Fraud Section in conjunction with its Medicare Fraud Strike Force (MFSF) partners. The MFSF is a partnership among the Criminal Division, U.S. Attorney’s Offices, the FBI, Health and Human Services-Office of Inspector General (HHS-OIG) and the Drug Enforcement Administration (DEA). In addition, the operation includes the participation of the Veterans Affairs-OIG and the Department of Labor, various other federal law enforcement agencies and Texas State Medicaid Fraud Control Units.
The charges announced aggressively target schemes billing Medicare, Medicaid, TRICARE (a health insurance program for members and veterans of the armed forces and their families), Department of Labor-Office of Worker’s Compensation Programs, and private insurance companies for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals allegedly involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department.
These arrests come three weeks after the Department announced that the Health Care Fraud Unit’s Houston Strike Force coordinated the filing of charges against dozens in a trafficking network responsible for diverting over 23 million oxycodone, hydrocodone and carisoprodol pills.
“Today’s charges highlight the amazing work being done by the Department’s Medicare Fraud Strike Force and our partners in Texas,” said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division. “As we continue to dedicate resources to battle healthcare and opioid fraud schemes in Texas and elsewhere, we are shining an inescapable light on dirty doctors, clinic owners, pharmacists, and others who may have long believed they could perpetrate their frauds behind closed doors.”
U.S. Attorney Erin Nealy Cox said submitting false insurance claims or prescribing unnecessary medications, equipment, or treatments drains tax payer dollars and makes healthcare more expensive for everyone.
“Healthcare should revolve around patients’ well-being – not providers’ personal interests,” said Nealy Cox of the Northern District of Texas. “We cannot allow the healthcare industry to become bloated by fraud,” she said.
“Every dollar stolen from Medicare through fraud comes out of the pocket of taxpayers,” said U.S. Attorney Joseph D. Brown of the Eastern District of Texas. “These are real costs that help drive up the cost of medical services for everyone. It is important that there be real consequences for those who cheat the system.”
“Health care fraud undermines our country by driving up medical costs, wasting taxpayer dollars, and often harming patients,” said HHS – OIG Special Agent in Charge C.J. Porter. “Today’s takedown shows that we are fighting hard to protect Medicare and Medicaid and the patients served by those programs. Working closely with our law enforcement partners, our agents are determined to ensure fraudsters pay for their crimes.”
Among those charged in the Northern District of Texas are the following:
- Michael Charles Braddick, Kyle Martin Hermesch, and Bioflex Medical were charged for their alleged participation in a scheme to defraud the Department of Labor- Office of Worker’s Compensation Programs. Bioflex Medical is located in Dallas, Texas. The case is being prosecuted by Special Assistant U.S. Attorney Jennifer Bray.
- Nehaj Rizvi was charged for his alleged participation in a scheme to defraud Medicare through Life Spring Housecall Physicians, Inc., a company located in Dallas, Texas. The case is being prosecuted by Assistant U.S. Attorney Douglas Brasher.
- Dr. Brian Carpenter and Jerry Hawrylak were charged for their alleged participation in a scheme to defraud TRICARE through a compounding pharmacy located in Fort Worth, Texas. The case is being prosecuted by Trial Attorney Brynn Schiess of the Fraud Section.
- Leah Hagen and Michael Hagen were charged for their alleged participation in conspiracies to pay and receive kickbacks and launder money through Metro DME Supply and Ortho Pain Solutions, both durable medical equipment companies in Arlington, Texas. The case is being prosecuted by Trial Attorney Brynn Schiess.
- Nilesh Patel, Dr. Craig Henry, and Bruce Henry were charged for their alleged participation in a scheme to defraud TRICARE through marketing company RxConsultants and a compounding pharmacy located in Fort Worth, Texas. The case is being prosecuted by Trial Attorney Carlos Lopez of the Fraud Section
- Bruce Stroud and Bobbi Stroud were charged for their alleged participation in a scheme to defraud Medicare through New Horizons Durable Medical Equipment, Striffin Medical Supply, and 4B Ortho Supply, all durable medical equipment companies located in the Dallas/Fort Worth area of Texas. The case is being prosecuted by Trial Attorney Carlos Lopez.
- Jamshid Noryian, Dehshid Nourian, Christopher Rydberg, Leyla Nourian, Ashraf Mofid, Dr. Leslie Benson, Dr. Michael Taba, and Ali Khavarmanesh were charged for their alleged participation in a scheme to defraud the Department of Labor- Office of Worker’s Compensation and Blue Cross Blue Shield and conspiracies to launder money and evade the payment of taxes through Ability Pharmacy, Industrial & Family Pharmacy, and Park Row Pharmacy, all located in the Dallas/Fort Worth area of Texas. The case is being prosecuted by Assistant Chief Adrienne Frazior of the Fraud Section.
The charges and allegations contained in the indictments are merely accusations. The defendants are presumed innocent until and unless proven guilty.
The Fraud Section leads the MFSF, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. MFSF maintains 15 strike forces operating in 24 districts. Since its inception in March 2007, MFSF has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. In addition, HHS Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.