A Houston doctor and a group home owner have been accused of participating in a massive $5.2 million Medicare fraud scheme.
According to the indictment, Walid H. Hamoudi, M.D., 63, of Houston, and Geraldine J. Caroline, 49, of Houston, allegedly caused the submission of false and fraudulent claims for partial hospitalization program (PHP) services to Medicare through a Houston hospital.
The indictment alleges that the defendants and their co-conspirators submitted or caused to be submitted approximately $5.2 million in claims to Medicare and over $380,000 in claims to Medicaid for PHP services purportedly provided by the hospital, when, in fact, the PHP services were medically unnecessary or never provided.
Hamoudi allegedly paid Caroline kickbacks to send her group home residents to the hospital to receive PHP services even though the patients did not qualify for or receive the services.
The charges come just days before Mohammad Khan, an assistant administrator at the hospital, is set to be sentenced for his role in the scheme. Khan pleaded guilty to one count of conspiracy to commit health care fraud, one count of conspiracy to pay illegal kickbacks and five counts of paying illegal kickbacks in February 2012.
Earnest Gibson III, the president of the hospital, along with his son Earnest Gibson IV, Regina Askew and Robert Crane, were convicted for their roles in the scheme in October 2014. William Bullock III, Robert Ferguson, Waddie McDuffie, Sharonda Holmes and Leslie Clark have pleaded guilty for their roles in the scheme.
Hamoudi and Caroline are expected to make their initial appearances in federal court in Houston today.
The case was investigated by the FBI, IRS-CI, HHS-OIG and the MFCU, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas. The case is being prosecuted by Trial Attorney Ashlee C. McFarlane of the Criminal Division’s Fraud Section.
The charges contained in an indictment are merely accusations, and a defendant is presumed innocent unless and until proven guilty.
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Key Facts
- State: Texas
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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