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Thirteen Years

Healthcare-Medicare-15
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Naomi Moore was the owner of two Houston based businesses, Friend’s Place and Metro Health Services, that were both advertised as home health care service businesses. But after thirteen years of receiving and reimbursing invoices from Moore, the Department of Health and Human Services learned that the only services that Friend’s Place and Metro Health Services offered were fraud. Moore pleaded guilty on April 7, 2022.

Moore could consider offering a class titled “Business Longevity” since she will be having some free time soon. Thirteen years is a long time to operate a business and more exceptional if the bulk of revenue is from frauding the government. From May 2006 to June 2019, Moore billed Medicare by fraudulently using names of beneficiaries that were not patients of Metro’s or Friend’s Place. In fact, they did not need home health services or were not treated by a physician or had never even been patients.

Moore’s secret to her success may have been because she knew her customer (the government) and to how bill a fair price (how about millions?). Moore created false documents and billed Medicare for approximately $10.7 million in purported home health services. The federal health insurance paid nearly $6.8 million on those claims.

Fortunately for Moore, her prison term was considered based on the financial damage and not the time the fraud was committed. On August 16, 2022, the U.S. court imposed the statutory maximum of 60 months (five years or barely a third of the time Moore committed the fraud) to be immediately followed by three years of supervised release. No allowances were granted given the large amount of money involved in the scheme.

Great by the Texas Attorney General’s Medicare Fraud Control Unit on its continual investigations in Medicare fraud.

Today’s Fraud of the Day is based on an article “Houston woman to serve fed time after creating bills for fake patients in $10M Medicare scheme, DOJ says” published by Houston News on August 18, 2022

A 59-year-old Houston female has been sent out to government prison following her conviction of devoting and conspiracy to devote healthcare scams, the United States Lawyer’s Office introduced. Naomi Moore pleaded guilty on April 7.

On Tuesday, U.S. Area Court Charles Eskridge enforced the statutory maximum of 60 months to be immediately followed by 3 years of monitored launch. In handling down the prison terms, Judge Eskridge noted a variance would not appropriate given the amount of money involved in the scheme.

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