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Terminal Fraudster

Confident  Doctor shaking hands with patients talk in the hospital
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

The former head of Novus and Optimum Health Services has pleaded guilty to conspiracy to commit healthcare fraud and healthcare fraud. Bradley J. Harris, 39, admitted in court to using his hospice business to defraud Medicare and Medicaid out tens of millions of dollars.

Harris owned and operated Novus and Optimum Health Services, which provided hospice services and end of life care to patients. He admitted that from 2012 to 2016, he participated in a fraudulent billing scheme which defrauded Medicare and Medicaid programs.

This scheme centered around Harris fraudulently billing Medicare and Medicaid for hospice services that were not provided, not directed by a medical professional, or that were provided to patients who were not actually eligible for hospice care.

He also admitted that he used blank, pre-signed controlled substance prescriptions to give patients drugs without a physician’s input. (An accountant by trade, I wonder if Harris just woke up and decided he wanted to play doctor.)

Mr. Harris admitted that two of his co-conspirators, Dr. Mark Gibbs and Dr. Laila Hirjee, frequently certified that his hospice patients faced terminal illnesses without actually examining the patients in person. Medicare defines a “terminal” patient as one with a life expectancy of six months or less. Most of Harris’ patients did not meet this requirement. (It takes a special kind of fraudster to deceive individuals into thinking that they are terminally ill.)

Both Dr. Gibbs and Dr. Hirjee were paid around $150 for each false order they signed. In addition, Dr. Gibbs, Dr. Hirjee, and Dr. Charles Leach, provided Harris with blank controlled substance prescription pads. These pads allowed Harris to “prescribe” schedule II-controlled substances to hospice beneficiaries without the guidance of a medical professional.

In 2014, Harris expanded on his fraudulent billing scheme by enrolling an influx of first-time hospice patients so that he could avoid exceeding Medicare’s aggregate hospice cap. He did this by partnering with Express Medical. Express Medical granted Harris access to potential patient’s confidential medical information in return for using Express Medical for any laboratory services and home health visits Novus conducted. (Those who break the law together, also go to jail together.)

Harris’ wife and other Novus staff then called on individuals that had at some point been patients of Express Medical, to recruit them for Novus hospice services, regardless of whether they were eligible to receive benefits. (It sounds like everyone from his wife to the intern was involved in this scheme.)

When the Center for Medicare & Medicaid Services suspended Novus based on suspicion of fraud, Harris transferred patients from Novus to a new company, “Company A.” Dr. Gibbs became the medical director for “Company A,” which used Novus staff and transferred hospice reimbursements back to Novus’ bank accounts. (But in the end, he was unable to fool the agency.)

This scheme defrauded Medicare and Medicaid programs out of tens of millions of dollars. Harris faces up to 14 years in federal prison when sentenced on August 3, 2021. Ten of Mr. Harris’ co-defendants, including Dr. Leach, have already pleaded guilty. Four more, including Dr. Gibbs and Dr. Hirjee, are expected to stand trial. (I’m sure that when the government is done with all who were involved, their scheme will be considered officially terminated.)

Today’s Fraud of the Day comes from a Department of Justice press release, “Novus Hospice CEO Pleads Guilty to Healthcare Fraud,” dated March 19, 2021.

The CEO of a local hospice agency has pleaded guilty to defrauding Medicare and Medicaid, announced Acting U.S. Attorney for the Northern District of Texas Prerak Shah.

Bradley J. Harris, the 39-year-old former head of Novus and Optimum Health Services, pleaded guilty on Friday to conspiracy to commit healthcare fraud and healthcare fraud.

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