Group Home Owners Sentenced in $1 Million Medicare Fraud Scheme
A Texas married couple was sentenced today for a $1 million Medicare fraud scheme, including violations of the federal Anti-Kickback Statute.
Department of Justice Press Release Number: 22-1275 - Topic(s): Health Care Fraud
Lindell King, 53, of Missouri City, was sentenced to 60 months in prison. Ynedra Diggs, 45, also of Missouri City, was sentenced to 70 months in prison. King and Diggs were also ordered to pay $537,992.55 in restitution.
On April 4, King and Diggs were convicted after trial in the Southern District of Texas of conspiracy to defraud the United States and to pay and receive health care kickbacks, and multiple substantive violations of the Anti-Kickback Statute.
According to court documents and evidence presented at trial, both Diggs and King were patient recruiters who owned and operated group homes in which Medicare beneficiaries lived. In exchange for sending their group home residents to the Behavioral Medicine of Houston (BMH), a community mental health center that purported to provide partial hospitalization services, BMH paid Diggs, King, and other patient recruiters illegal kickbacks in cash and by check, often concealed as payment for “transportation” or other sham services. During the course of the conspiracy, BMH fraudulently billed approximately $1 million to Medicare in claims related to patients it received in exchange for the kickbacks paid to Diggs and King.
Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; U.S. Attorney Jennifer B. Lowery for the Southern District of Texas; Acting Special Agent in Charge Jason Meadows of the Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Region; Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division; Special Agent in Charge James H. Smith III of the FBI Houston Field Office; and Chief William Marlowe of the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.
The HHS-OIG, FBI, and MFCU investigated the case.
Trial Attorney Monica Cooper and Acting Assistant Chief Brynn Schiess of the Criminal Division’s Fraud Section are prosecuting the case.
The Fraud Section leads the Criminal Division’s efforts to combat healthcare fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who collectively have billed the Medicare program for more than $19 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.
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BMH fraudulently billed approximately $1 million to Medicare in claims related to patients it received in exchange for the kickbacks paid to Diggs and King.