Thursday, February 6, 2014

Hospital administrator and businessmen sentenced to prison for submitting fraudulent cost reports to Medicare

MONROE, La. (AP) — A former Madison Parish Hospital administrator and two of its vendors have been sentenced for health care fraud.
U.S. Attorney Stephanie A. Finley said Tuesday that U.S. District Judge Robert G. James sentenced Charles W. Alford, 71, of Newellton, to 37 months in prison and ordered him to pay $1.3 million in restitution.
James also sentenced Barney W.I. Hughes IV, 45, of Keller, Texas, to a year in prison and ordered him to pay $566,874 restitution and Henry R. Ham, 65, of West Monroe, to 14 months in prison and $817,000 in restitution.
According to evidence presented at Monday's guilty plea, Alford was hospital administrator for Madison Parish Hospital in Tallulah; Hughes served as owner of Tech Solutions of Keller, Texas; and Ham, was owner of Insurance World in Monroe.
Both Hughes and Ham paid Alford a combined total of more than $1.3 million in kickbacks for his approval and continuation of their business agreements.
Madison Parish Hospital leased equipment and personnel from Tech Solutions to operate the hospital's nuclear medicine and ultrasound departments.
At no time did Alford or Hughes disclose to the hospital's board or Medicare that they had an exclusive agreement. From October 2006 to June 2012, the hospital paid Hughes' company $2,029,504, and Hughes paid Alford $566,874 of that total. They submitted fraudulent cost reports to Medicare at least six times from December 2006 to 2011.
Madison Parish Hospital purchased a majority of its health insurance and life insurance products from Ham. Alford and Ham negotiated and set the insurance policy rates and Alford approved Ham's billings as well as the hospital's payments to Ham.
From 2007 through April 2012, the hospital paid Ham $4,979,487, and Ham paid Alford $817,000 of that total. They submitted fraudulent cost reports to Medicare at least five times from December 2007 to 2011.

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