An elaborate $30 million Medicare fraud indictment has resulted in a Louisiana home health company owner and three former home health workers pleading guilty to health care fraud-related charges, the Justice Department announced. The case has grabbed media attention not only for the high dollar amount but for claims of racial bias and a scam related to the Deep Water Horizon oil spill.
Lisa Crinel, former owner and operator of Abide Home Care Services Inc., was indicted last March as part of a sweeping charge that involved 20 individuals.
As operator, Crinel was charged with Medicare fraud for allegedly hiring “house doctors” to sign home health orders for Medicare beneficiaries who did not need home care. The house doctors reportedly falsely signed home health orders—regardless of a beneficiary’s diagnoses, homebound status or needs—in return for monthly payments that were fraudulently characterized as medical consultant or director fees.
Following the indictment, Crinel, who is also the 2004 Zulu Queen, repeatedly attempted to have all evidence seized in a 2014 raid thrown out, alleging that federal authorities acted with racial bias when they seized the more than $1 million in property a year before she was indicted. She alleged that prosecutors seized the property in an effort to cripple her financially and would not have acted in the same way against a white defendant in a similar case. Crinel also said in a civil lawsuit that she had a romantic relationship with the husband of a federal judge who signed the search warrant for the FBI in the investigation in 2014, Louisiana news outlet WDSU News reported.
Crinel’s daughter, Wilneisha Harrison Jakes, who was serving as chief administrative officer for Abide, was also deeply involved with the scam and indicted. The company was also accused of hiring marketers to increase referrals, which are typically driven by health care professionals. Authorities allege that the company and defendants were involved in more than $30 million in Medicare fraud.
Crinel pled guilty to two counts of conspiracy to commit health care fraud and conspiracy to pay and receive illegal kickbacks. As a result, Crinel, 52, faces a maximum prison term of 10 years, a $250,000 fine and 3 years of supervised release following imprisonment. Her sentencing is scheduled for Jan. 13, 2016. She owes restitution in the amount of $16,088,222 jointly with several co-defendants.
Crinel and Abide were also accused of falsely applying for wage relief in the aftermath of the oil spill in the Gulf of Mexico caused by BP’s Deepwater Horizon oil rig. According to authorities, the home care company pocketed more than $37,000 in reimbursements from BP.
Threasa Adderley, 64, pled guilty to Count 2 of the Indictment for conspiracy to pay and receive illegal kickbacks. Adderley was a physician with Abide who acted as a medical consultant and received more than $48,000 of Medicare funds for medically unneccessary home health billing, court documents show.
Rhonda Maberry, 48, pled guilty to conspiracy to commit health care fraud. Mayberry worked as an Advanced Practice Registered Nurse with Abide and received payments totaling approximately $272,982.61 from Medicare between January 2006 and December 2012 for medically unnecessary home health.
Adderley and Maberry face a maximum term of 5 years imprisonment, a fine of $250,000, a supervised release term of up to 3 years and restitution.
Seila Mathieu, 46, pled guilty to aiding and abetting the theft of Government money of property and faces a maximum term of 1 year imprisonment, a fine of $100,000, a term of supervised release up to one year and restitution. Matheiu worked as a RN for Abide and received approximately $48,800 for performing false and fraudulent home health certifications that were largely medically unnecessary.
Twenty individuals were indicted conspiracy to commit health care fraud, conspiracy to defraud the United States and to receive and pay health care kickbacks, and the prosecutors warned that the case has not concluded for other individuals involved.
“Today’s guilty pleas are further evidence of our commitment to fighting health care fraud in our region,” U.S. Attorney Kenneth Polite said in a prepared statement. “Those engaged in similar criminality should take note: our investigation in this case, and other related matters, is on-going.”
Written by Amy Baxter