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$6.3 Million Medicare Scam Unfolds in Houston
A brazen scheme to defraud Medicare of $6.3 million has come to an end with the guilty plea of a Houston health care owner.
Clifford Ubani, 52, pleaded guilty to conspiracy to commit health care fraud before U.S. District Court Judge Gray Miller in Houston. In his plea, Ubani admitted to defrauding Medicare of $6.3 million.
Ubani was an owner and operator of two health care companies, Family Healthcare Services and Family Healthcare Group. Both companies maintained valid Medicare provider numbers and submitted claims for medically unnecessary and/or not provided durable medical equipment and services.
According to court documents, Ubani hired co-conspirators to recruit Medicare beneficiaries for the purposes of filing claims with Medicare for durable medical equipment and services. Once Medicare beneficiary numbers were obtained, the companies submitted claims to Medicare, including for orthotic devices and skilled nursing services that were not medically necessary and/or not provided.
Ubani admitted to paying kickbacks to the recruiters for their referrals. Family Healthcare Services submitted approximately $1.1 million in fraudulent claims to Medicare, while Family Healthcare Group was paid approximately $5.2 million by Medicare for the submission of fraudulent claims.
At sentencing, scheduled for February 25, 2011, Ubani faces a maximum sentence of 10 years in prison.
The case is being prosecuted by Trial Attorneys Charles D. Reed and Sam S. Sheldon of the Criminal Division’s Fraud Section, and is part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section.
Since their inception in March 2007, Medicare Fraud Strike Force operations in seven districts have obtained indictments of more than 810 individuals who collectively have falsely billed the Medicare program for more than $1.85 billion.
For more information on the Health Care Fraud Prevention and Enforcement Action Team (HEAT), visit www.stopmedicarefraud.gov.
Key Facts
- State: Federal
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release ↗
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