Two Doctors, A Nurse, and a CEO

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Two doctors and a nurse from Gainesville, Tex., have been convicted of healthcare fraud and could face up to 35 years in federal prison. Consequently, Dr. Mark E. Gibbs, Dr. Laila Hirjee, and nurse Tammie Little face decades behind bars in federal prison.

A federal jury found Novus Health Services Medical Directors Gibbs and Hirjee, along with Novus RN Little, guilty of conspiracy to commit healthcare fraud. The jury also found Gibbs guilty of two counts of healthcare fraud and one count of obstruction of justice; Hirjee guilty of three counts of healthcare fraud; and, Little guilty of three counts of healthcare fraud.

Novus is a Frisco-based company that provides hospice care services in the area. According to evidence presented at trial, the defendants helped Novus CEO Bradley Harris defraud Medicare by submitting false claims to Medicare for hospice services, providing kickbacks for referrals, violating HIPAA to recruit beneficiaries, and destroying documents to conceal the fraud from Medicare. (These are definitely not behaviors that Medicare encourages.)

Harris testified against his former employees after pleading guilty prior to trial. (Anything to save himself, I’m sure.) Harris told the jury that he and Novus nurses determined which patients would be admitted to or discharged from hospice care. They also decided which drugs and dosages patients would receive. They never conferred with licensed medical professionals during the decision-making process. (Why consult a doctor when you can play God by making life or death decisions?)

The co-conspirators relied upon Novus doctors, including Gibbs and Hirjee, to falsely assert that they had examined these patients face-to-face, despite the fact that no examinations occurred. Hirjee and Gibbs also engaged in the prescription of Schedule II controlled substances, such as morphine and hydromorphone, by pre-signing blank prescription pads. Harris and the nurses then used the pre-signed prescription pads to dispense medications to patients. (They were handing out highly addictive medications like they were tootsie rolls.) Harris also paid Gibbs and Hirjee kickbacks, disguised as medical directory salaries, to incentivize them to refer patients to his facilities.

Medicare began to suspect Novus of fraud and suspended payment to Novus over concerns about billing. As a result, Harris moved employees to a new hospice company and continued to bill Medicare for hospice services under the name of the new company. (They weren’t smart enough to stop and learn from their mistakes.)

In total, Medicare and Medicaid paid the Novus entities approximately $40 million for hospice services before the scheme was ended by authorities. Dr. Mark E. Gibbs, Dr. Laila Hirjee, and nurse Tammie Little are scheduled for sentencing on Sept. 28. Hirjee faces up to 60 years in federal prison and Little faces up to 40 years.

Twelve co-defendants, including Harris, pleaded guilty prior to trial. One defendant was sentenced to probation and the remaining defendants are facing between two and 14 years in federal prison.

Today’s Fraud of the Day comes from an article, “Gainesville doctor found guilty in Medicare scheme, sentencing scheduled for September,” published by Gainesville Daily Register on May 27, 2021.

A Gainesville doctor recently convicted of healthcare fraud could face up to 35 years in federal prison.

Chief U.S. District Judge Barbara M.G. Lynn is set to sentence Dr. Mark E. Gibbs, Dr. Laila Hirjee and nurse Tammie Little at 9 a.m. Tuesday, Sept. 28, at the federal courthouse in Dallas, said Erin Dooley, spokeswoman for the United States Attorney’s Office Northern District of Texas.

 

 

 

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.