Three medical professionals who helped a local hospice agency scam Medicare have been convicted of healthcare fraud, announced Acting U.S. Attorney for the Northern District of Texas Prerak Shah.
On Monday, a federal jury found Novus Health Services Medical Directors Dr. Mark Gibbs and Dr. Laila Hirjee, along with Novus RN Tammie Little, guilty of conspiracy to commit healthcare fraud.
Additionally, the jury found Dr. Gibbs guilty of two counts of healthcare fraud and one count of obstruction of justice, Dr. Hirjee guilty of three counts of healthcare fraud and one Title 21 drug offense, and Ms. Little guilty of three counts of healthcare fraud. (Dr. Gibbs was acquitted of one of the three health care fraud counts brought by the government.)
According to evidence presented at trial, the defendants helped Novus CEO Bradley Harris defraud Medicare by submitting materially false claims for hospice services, providing kickbacks for referrals, violating HIPAA to recruit beneficiaries, and destroying documents to conceal the fraud from Medicare.
Mr. Harris, who pleaded guilty prior to trial, testified against his former employees.
He told the jury that instead of relying on the expertise of licensed medical professions, he and Novus nurses, including Ms. Little, determined which patients would be admitted to or discharged from hospice care, as well as which drugs and dosages they would receive.
They relied upon Novus doctors, including Dr. Gibbs and Dr. Hirjee, to certify that they had examined these patients face-to-face, when no such examinations had occurred, Mr. Harris testified.
Witnesses also testified that Dr. Hirjee and Dr. Gibbs engaged in the prescription of Schedule II controlled substances, such as morphine and hydromorphone, by pre-signing blank C2 prescriptions and giving those to Brad Harris and others at Novus to let them prescribe controlled substances without any physician oversight.
As Director of Operations Melanie Murphey testified on day five of trial, “I was the doctor.”
Mr. Harris and the nurses used pre-signed prescription pads, prepared by Dr. Gibbs, Dr. Hirjee, and other Novus doctors, to dispense medications like morphine to patients. Mr. Harris paid also Dr. Gibbs and Dr. Hirjee kickbacks – disguised as medical directory salaries – to induce them to refer patients to his facilities.
When Medicare suspended payment to Novus over concerns about billing, Mr. Harris, Dr. Gibbs, and others moved patients and employees to a new hospice company and continued to bill Medicare for hospice services.
In total, Medicare and Medicaid paid the Novus entities approximately $40 million dollars for hospice services before the companies were shut down.
“With today’s guilty verdicts, we are one step closer to bringing this sordid case to a close,” said Acting U.S. Attorney Shah. “These medical professionals behaved unconscionably, allowing Mr. Harris – an accountant – to dictate end-of-life care for suffering patients. The Northern District of Texas will not stand for this sort of misconduct.”
Dr. Hirjee now faces up to 60 years in federal prison, Dr. Gibbs faces up to 35 years, and Ms. Little faces up to 40 years.
Twelve of their codefendants – Novus CEO Brad Harris, his wife, Novus Vice President of Patient Services Amy Harris, Novus Director of Operations Melanie Murphy, Novus Medical Director Charles Leach, Novus Medical Director Reziuddin Siddique, Novus Medical Director Syed Aziz, Novus Vice President of Marketing Samuel Anderson, Novus Director of Marketing Slade Brown, Novus RN Jessica Love, Novus triage RN Patricia Armstrong, Novus LVN Taryn Stewart, and Ali Rizvi, the owner of a separate physician home visit company – pleaded guilty prior to trial and are facing between two and 14 years in federal prison.
The Federal Bureau of Investigation’s Dallas Field Office, the U.S. Department of Health & Human Services Office of Inspector General (HHS-OIG), and the Texas Attorney General’s Medicaid Fraud Control Unit conducted the investigation. Assistant U.S. Attorneys Donna Strittmatter Max, Marty Basu, and Chad Meacham are prosecuting the case with Assistant U.S. Attorneys Stephen Gilstrap, Gail Hayworth, and Brian McKay. Chief U.S. District Judge Barbara M.G. Lynn presided over the trial.
