Joseph Edem, Health Care Fraud, Texas 2013

Crime Pays, But Not For Long: Texas Businessman Faces Prison Time For $19+ Million Health Care Fraud Scheme

Houston, TX - In a shocking turn of events, local businessman Joseph Edem, 53, of Richmond, has been convicted of conspiracy to commit health care fraud, a scheme that netted him over $19 million in ill-gotten gains.

According to court documents, Edem, along with former doctor Donald Gibson II, 56, of Sugarland, orchestrated a massive health care scam that involved medically unnecessary diagnostic testing and physical therapy.

The indictment alleged that Gibson ordered, prescribed, and authorized the unnecessary tests, which were then billed to Medicare and Medicaid for payment under his billing number.

Between January 2007 and January 2012, Gibson's alleged scheme caused over $19.4 million in medical claims to be submitted to the Medicare and Texas Medicaid programs, resulting in approximately $8.5 million being deposited into a bank account owned and controlled by Gibson.

Edem, who operated medical clinics under the names of other individuals to conceal his financial interest in the businesses, admitted to conspiring to cause the submission of false claims to the Medicare and Medicaid programs and sharing in the proceeds.

As part of his plea deal, Edem faces up to 10 years in federal prison and a possible $250,000 fine. Sentencing is set for May 28, 2013. The case against Gibson, Edem's former partner in crime, is still pending.

The investigation into Edem's health care scam was a joint effort involving multiple federal and state agencies, including the Railroad Retirement Board, Secret Service, Drug Enforcement Administration, FBI, the Texas Attorney General's Medicaid Fraud Control Unit, and the U.S. Department of Health and Human Services - Office of Inspector General.

Source: https://www.justice.gov/usao-sdtx/pr/local-businessman-convicted-19-million-health-care-fraud-scheme