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Four Convicted in $50 Million Medicare Fraud Scheme
In a stunning blow to the healthcare system, a jury in New Orleans has convicted four employees of medical service clinics for their roles in a $50 million Medicare fraud scheme.
Barbara Smith, M.D., 66, of Metairie, Louisiana; Roy Berkowitz, M.D., 69, of Slidell, Louisiana; Beverly Breaux, 67, of New Orleans; and Joe Ann Murthil, 57, of New Orleans, were found guilty on all counts after a five-day jury trial before Chief U.S. District Court Judge Sarah S. Vance of the Eastern District of Louisiana.
The scheme, which spanned over 10 years, involved false claims that thousands of Medicare recipients were homebound and required nursing or therapy services. Smith and Berkowitz allegedly made these false claims, while Breaux, a registered nurse, certified that these patients were homebound and falsely claimed to have treated patients that she had not seen. Murthil, the office manager and biller, assisted with the payment of illegal kickbacks to patient recruiters and submitted false claims to Medicare.
The companies involved in the scheme submitted more than $56 million in claims to Medicare between 2007 and 2014, with the vast majority being fraudulent. Medicare paid out approximately $50.7 million on these claims.
Assistant Attorney General Leslie R. Caldwell of the Criminal Division, U.S. Attorney Kenneth A. Polite of the Eastern District of Louisiana, Special Agent in Charge Michael J. Anderson of the FBI’s New Orleans Field Office, Special Agent in Charge Mike Fields of the Department of Health and Human Services’ Office of the Inspector General, and Louisiana Attorney General James D. “Buddy” Caldwell made the announcement.
The case was investigated by the FBI, HHS-OIG, and the Louisiana Attorney General’s Medicaid Fraud Control Unit, and was brought as part of the Medicare Fraud Strike Force. The case was prosecuted by Trial Attorneys William Kanellis and Antonio Pozos and Assistant Chief Ben Curtis of the Criminal Division’s Fraud Section.
Sentencing for the defendants is scheduled for Aug. 26, 2015. In total, 13 defendants have been charged for their roles in this scheme, with nine others previously pleading guilty.
This case is part of the Medicare Fraud Strike Force, which has charged nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5 billion since its inception in March 2007.
To learn more about the Health Care Fraud Prevention and Enforcement Team (HEAT), visit www.stopmedicarefraud.gov.
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Key Facts
- State: Louisiana
- Category: Fraud & Financial Crimes|White Collar Crime
- Source: DOJ Press Release â†â€â€
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