Two Doctors, A Nurse, and a CEO

521
Male hands counting dollars, black salary, money laundering, illegal business, stock footage

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.

 

 

 

SHARE
Previous articleA Losing Hand
Next articleFraud and All That Jazz
Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.