Thirteen individuals have been sentenced to a combined 84 years in federal prison for their role in a $27 million healthcare fraud by Novus Health Services, according to a press release from the office of U.S. Attorney for the Northern District of Texas, Chad E. Meacham.
Staff at Novus Health Services, a Dallas-based hospice agency, defrauded Medicare by submitting materially false claims for hospice services, violating the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to recruit beneficiaries, and providing kickbacks for referrals.
In addition, employees at Novus prescribed Schedule II controlled substances to patients without consulting medical professionals. Examples of Schedule II controlled substances include hydromorphone (Dilaudid), methadone (Dolophine), meperidine (Demerol), oxycodone (OxyContin, Percocet), fentanyl (Sublimaze, Duragesic), morphine, opium, codeine, and hydrocodone.
Novus CEO Bradley J. Harris pleaded guilty on March 19, 2021, to one count of conspiracy to commit healthcare fraud and one count of healthcare fraud.
“Mr. Harris scammed federal healthcare programs out of millions of dollars, and worse yet, denied vulnerable patients the medical oversight they deserved, writing pain prescriptions without physician input and allowing terminally ill patients to go unexamined,” said Prerak Shah, who was Acting U.S. Attorney at the time of Harris’ plea.
Harris admitted that he billed Medicare and Medicaid for hospice services that were never provided or recommended by a medical professional. He also admitted to billing Medicare and Medicaid for services provided to patients who were not eligible for hospice care.
In May 2021, Harris testified against two of his accomplices, Dr. Mark Gibbs and Dr. Laila Hirjee, who elected to proceed to trials. Gibbs and Hirjee were Medical Directors at Novus. Harris told jurors that he and Novus nurses, including Tammie Little, determined which patients would be admitted or discharged from hospice care while also prescribing drugs to those patients without consulting licensed medical professionals.
Novus doctors, including Dr. Gibbs and Dr. Hirjee, conspired with Harris and other employees and fraudulently certified that the patients had been examined face-to-face. Harris testified that no such examinations occurred.
Harris also testified that Gibbs, Hirjee, and another physician, Dr. Charles Leach, left him blank controlled substance prescriptions, which allowed Harris, an accountant by trade, to “prescribe” Schedule II controlled substances to hospice beneficiaries without consulting medical professionals.
Harris also admitted that he avoided exceeding Medicare’s aggregate hospice cap by enrolling an influx of first-time hospice patients. To achieve his aim, Harris conspired with another company called Express Medical which gave him access to its potential patients’ confidential medical records. In return, Novus used Express Medical for laboratory services and home health visits.
Novus employees and Amy Harris, Novus VP of Patient Services and wife of Harris, called on individuals who had been patients of Express Medical to recruit them for hospice care services, regardless of their eligibility status.
Based on credible allegations of fraud, the Center for Medicare & Medicaid Services suspended Novus. However, Harris transferred patients from Novus to a new hospice company, where Gibbs became the medical director. According to Harris, the new company also used Novus employees and funneled hospice reimbursement back to Novus.
Harris was sentenced to more than 13 years in federal prison, while his wife, who pleaded guilty to one count of conspiracy to obstruct justice, was sentenced to 38 months.
Gibbs was found guilty on one count of conspiracy to commit healthcare fraud, two counts of healthcare fraud, and one count of conspiracy to obstruct justice and was sentenced to 13 years in federal prison.
Hirjee was convicted on one count of conspiracy to commit healthcare fraud, three counts of healthcare fraud, and one count of unlawful distribution of a controlled substance. She will serve 10 years in prison.
Tammie Little, a Novus Registered Nurse, was also convicted at trial on one count of conspiracy to commit healthcare fraud and three counts of healthcare fraud and aiding and abetting. Little was sentenced to 33 months behind bars.
The following individuals were also sentenced in connection with the Novus fraud case:
- Novus VP of Marketing, Sam Anderson, admitted to one count of conspiracy to commit healthcare fraud and was sentenced to 33 months in federal prison.
- Patricia Armstrong, a Novus triage nurse, will serve seven years in federal prison after she pleaded guilty to one count of conspiracy to commit healthcare fraud.
- Novus Director of Marketing Slade Brown admitted to one count of conspiracy to commit healthcare fraud and will serve four years behind federal bars.
- Dr. Charles Leach, Novus Medical Director, who pleaded guilty to one count of conspiracy to commit healthcare fraud, was sentenced to more than four years in federal prison.
- Jessica Love, another Novus Registered Nurse, was sentenced to more than eight years in prison after she pleaded guilty to one count of conspiracy to commit healthcare fraud.
- Novus Director of Operations Melanie Murphey will serve over five years in federal prison after he pleaded guilty to conspiracy to commit healthcare fraud.
- Taryn Stuart, Novus Licensed Vocational Nurse, got eight years in prison for her role in the fraud case after pleading guilty to one count of conspiracy to commit healthcare fraud.
- Ali Rizvi, who owns Express Medical, got the shortest punishment of all 13 defendants after he pleaded guilty to one count of wrongful use of individually identifiable health information. He was sentenced to 18 months in federal prison.
The Federal Bureau of Investigation’s Dallas Field Office, alongside the Texas Attorney General’s Medicaid Fraud Control Unit and the U.S. Department of Health & Human Services Office of Inspector General (HHS-OIG), investigated the case.
Assistant U.S. Attorneys Marty Basu and Donna Strittmatter Max prosecuted the case along with Meacham.