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.

http://www.khou.com/news/national/243660141.html

Husband, wife and business associate charged with health care fraud

William Owuama, 55, Marla Owuama, 46, and Florida Holiday Island, 64, all of Houston, have been charged in an eight-count indictment alleging conspiracy to commit health care fraud, health care fraud and conspiracy to violate the federal anti-kickback statute, announced United States Attorney Kenneth Magidson.

The sealed indictment, returned Jan. 22, was unsealed this afternoon as all three defendants made their initial appearance before U.S. Magistrate Judge Frances Stacy at 2 p.m. At the hearing, Judge Stacy permitted Marla Owuama and Island be released upon posting bond. Upon surrendering his passport, William Owuama is also expected to be released upon posting bond.

The indictment alleges William Owuama was the owner of Wilmar Healthcare Systems, his wife Marla was a registered nurse and Island transported patients to and from the clinic. According to allegations, they not only paid patients for visiting the clinic in violation of the anti-kickback statute, but billed Medicare and Medicaid for vestibular testing that was never performed. The indictment also alleges the clinic billed Medicare and Medicaid under the provider number of a local doctor while that doctor was incarcerated on unrelated charges. From January 2006 through October 2009, Medicare and Medicaid paid Wilmar more than $4 million based on the alleged fraudulent claims.

If convicted, all three defendants face up to five years in federal prison and a $250,000 fine for conspiring to commit healthcare fraud and violating the anti-kickback statute. The Owuamas also face up to 10 years in prison and a $250,000 fine for the substantive healthcare fraud charges.

The investigation leading to the charges in this case was conducted by the U.S. Department of Health and Human Services – Office of Inspector General and the Texas Attorney General’s Office Medicaid Fraud Control Unit. Special Assistant United States Attorney (SAUSA) Adrienne Frazior and AUSAs Andrew Leuchtmann and John Pearson are prosecuting the case.

http://www.yourhoustonnews.com/memorial/news/husband-wife-and-business-associate-charged-with-health-care-fraud/article_13e3906b-a9f5-5b62-973f-9b3c3b2b3f2a.html?mode=jqm

USDA awards millions for telemedicine

Posted on Feb 05, 2014

By Bernie Monegain, Editor

Ozarks Medical Center in Missouri and Flagstaff Medical Center in Arizona are just two hospitals in 25 states across the country that will receive federal funding for telemedicine projects. Agriculture Secretary Tom Vilsack announced nearly $16 million in USDA grants would be disbursed for distant learning and telemedicine services.
The USDA's Distance Learning and Telemedicine Loan and Grant program provides funding to rural hospitals, clinics, schools and libraries for equipment and technical assistance for telemedicine and distance learning. Grant recipients must demonstrate that they serve rural America, prove there is an economic need and provide at least 15 percent in matching funds.


Since 2009, USDA has invested almost $150 million in the Distance Learning and Telemedicine program. The investments complement other USDA efforts to improve rural communications. In FY 2013, USDA provided $305 million in loans for broadband infrastructure. These loans will result in new or upgraded broadband service for about 120,000 rural households, businesses and community institutions once the projects are completed.



Hospitals receiving telemedicine grants are:

Alaska
Chugachmiut: $180,656
Funds will be used to re-establish a telemedicine network between Native village sites in the Chugach region and offices in Seward and Anchorage. Clinics in the villages of Tatitlek, Chenega, Port Graham and Nanwalek will be linked with Anchorage and the North Star Clinic.

Alaska Native Tribal Health Consortium: $114,842
Funds will be used to purchase video teleconferencing equipment systems for virtual sessions between patients and health care providers. It is projected that nearly 3,200 people will benefit in the first year alone. The Alaska Native Tribal Health Consortium includes nine organizations that deliver innovative telehealth solutions throughout the  Alaska Federal Health Care system.

Arizona
Flagstaff Medical  Center: $129,412
Funds will be used to purchase digital electronics and software for a telemedicine system linking the Flagstaff medical center with clinics in Coconino, Apache, Mohave and Navajo Counties. This system will connect local caregivers and their patients with specialists at Flagstaff.

Kentucky
Norton Healthcare Foundation: $259,607
Funds will be used to expand the Norton Rural Medicine Initiative. The equipment will allow Norton physicians and other medical specialists in Louisville to consult medical staff and their patients at Breckinridge Health and Westlake Regional Hospitals in Kentucky; and Scott Memorial Hospital in Indiana. With the telemedicine network, patients no longer will have to travel for pulmonary, cardiology, neurology, infectious disease and critical care.

Maine
Community Health & Counseling Services: $103,235
Funds will be used to purchase in-home patient monitors, medication dispensers and screening monitors for Community Health and Counseling Services, which serves patients in Piscataquis and Washington counties with congestive heart failure, medication compliance issues, patients who need speech pathology to address swallowing disorders. The project is expected to reduce preventable hospital visits and emergency room visits, saving time and money.

Missouri
Ozarks Medical Center: $274,638
Funds will be used to buy equipment to expand medical services to Ozarks Medical Center's four hospitals and nine clinics. Services will include tele-stroke, tele-psychiatry, tele-speech therapy and tele-dermatology.

Harrison County Community Hospital District: $500,000
Funds will be used to purchase software and equipment for Harrison County’s teleradiology system. A Radiology Information System will be purchased to connect end-user workstations at clinics in Princeton, Cainsville and Bethany. The project will also fund a new telemedicine unit for the hospital's outpatient clinic. The hospital will be able to improve operations in several departments, including emergency, respiratory therapy
and cardiac rehabilitation.

Mercy Health: $382,748
Funds will be used to purchase equipment and devices for exam rooms in 11 sites in Missouri, Arkansas and Oklahoma. Physicians and other medical specialists at Mercy Hospital in St. Louis will use the audio/video equipment for face-to-face consultations, observation and diagnosis, and treatment planning.

Mississippi
University of Mississippi Medical Center: $378,360
Funds will help a consortium of rural hospitals in Mississippi acquire high-definition video teleconferencing units for their emergency rooms, and mobile units for ambulatory care at each hospital. The University of Mississippi Medical Center will make specialists and medical personnel available through the video network to respond interactively to live emergencies from any of the participating sites.

North Carolina
Grandfather Home for Children: $393,368
Funds will be used to install video teleconferencing equipment. Grandfather Home is a facility in Banner Elk, N.C., for abused and neglected children. Video conferencing will provide critical therapeutic services for children and a direct line of communication between children and their foster parents.

New Hampshire
Mary Hitchcock Memorial Hospital: $498,356
Funds will be used to purchase equipment and software to expand the telemedicine network at the Mary Hitchcock Memorial Hospital to new sites in New Hampshire and Vermont. After this expansion is deployed, the system is projected to provide medical expertise for more than 5,000 rural residents.

Mary Hitchcock Memorial Hospital: $500,000
Funds will be used to purchase telemedical carts and related equipment for 18 rural sites. The participating sites include rural acute care hospitals, ambulatory care sites, rehabilitation sites and behavioral health centers in
Woodsville, Littleton, Greenfield, Colebrook, New London, Whitefield, Lancaster and Groveton.

South Carolina
Hampton Regional Medical Center: $249,162
Funds will be used to purchase a variety of video teleconferencing equipment and digital exam devices for the medical center and nine end-user sites. Roper St. Francis Hospital in Charleston will serve as a hub site for medical specialists and video system management. The video teleconferencing platform will allow face-to-face consultations between patients and physicians and between local health care providers and medical staff at the hub site.

Washington
Kadlec Regional Medical Center: $329,269
Funds will be used to purchase telemedicine equipment for a consortium of 12 health care organizations serving 19 sites at rural clinics along the Columbia River in Eastern Oregon and Washington. The Medical Center and participating hospitals will offer a comprehensive array of services and consultations.

West Virginia
Davis Memorial Hospital: $74,189
Funds will be used to establish telemedicine consultations between physicians at Davis Memorial Hospital and the Cortland Acres (Tucker County), Pendleton Manor (Pendleton County) and Mansfield Place (Barbour County) nursing homes. Physicians will be equipped with iPads and video-enabling software to increase their availability to observe and provide diagnosis for residents and patients.
Also USDA gave several awards that combined funding for both distance learning and telemedicine.

Missouri
Citizens Memorial Hospital District, $175,989
Funds will be used to provide telemedicine equipment for a partnership led by Citizens Memorial Hospital. The hospital and its hub partners will provide telemedicine services to rural clinics in Pleasant Hope, Rockville, El Dorado Springs, Stockton, Greenfield, Buffalo, Montrose, Wheatland, Hermitage, Humansville, Appleton City and Deepwater.

Montana
Kalispell Regional Medical Center, $363,326
Funds will be used to help Kalispell Regional Medical Center provide 24/7 telemedicine consultation services in its nine
county area. The equipment will create a telemedicine service among the Western Montana Tele-neurology Network, Kalispell Regional Medical Center and critical access hospitals in the region.

New York
Jefferson-Lewis-Hamilton-Herkimer-Oneida Board of Cooperative Educational Services, $487,267
Funds will be used to purchase video teleconferencing units for 37 schools in the Jefferson Lewis Hamilton Herkimer Oneida jurisdiction, 15 of which have never been connected to a distance learning system before. LeMoyne College in Syracuse, Clarkson University in Potsdam, Jefferson Community College in Watertown, and the Syracuse University School of Medicine will be part of the teleconference network.

Oklahoma
Board of Regents of the University of Oklahoma Health Sciences Center, $500,000
Funds will be used to purchase state-of-the-art digital equipment and software for a telemedicine initiative hosted by the University of Oklahoma Health Science Center. The initiative will use video teleconferencing to offer geriatric services to Choctaw Nation clinical sites -- including Stilwell Community Hospital -- and Choctaw clinics in Hugo, Broken Bow, Stigler, Idabel, Talihina and Atoka, and general services to health care facilities in Fort Cobb, Grandfield and Tipton.

South Carolina
South Carolina Department of Juvenile Justice, $196,809
Funds will be used to provide video teleconferencing systems for the South Carolina Department of Juvenile Justice. The equipment will give students a better chance of obtaining work skills and higher education opportunities

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