The $27 million Novus Health Services fraud case has resulted in 84 years in federal prison for thirteen defendants. This sentencing follows former Novus and Optimum Health Services CEO Bradley J. Harris’s guilty plea earlier this year for fraudulent billing and a kickback scheme.
According to plea papers and evidence in trial, Dallas-based Novus defrauded Medicare by submitting false claims for hospice services, giving kickbacks for referrals, and violating HIPAA to recruit more patients. Employees at Novus also gave Schedule II controlled substances to patients without guidance from medical professionals and later moved patients to a new hospice company to avoid Medicare’s discipline.
Novus was one of the region’s largest hospice providers before it closed in 2015. When Harris pleaded guilty, he admitted billing Medicare and Medicaid for hospice services that were never rendered nor directed by a medical professional. He also admitted to giving services to ineligible patients. An accountant by trade, Harris used blank, pre-signed prescriptions to distribute controlled substances without physician oversight. He collaborated with Dr. Mark Gibbs and Dr. Laila Hirjee to certify that patients faced terminal illnesses without an examination and were paid $150 for every certification they signed.
Harris worked with Novus nurses to dispense drugs such as morphine and hydrocodone with pre-signed prescription pads. These patients were supposed to be supervised and seen face-to-face by Hirjee and Gibbs to certify that they were terminally ill. Staff often certified care plans without reviewing the patients and claimed to have seen the patients in person when they hadn’t.
Director of Operations Melanie Murphey said during the trial that she effectively was the doctor at Novus. Harris admitted to paying Novus physicians kickbacks disguised as medical director salaries to refer patients to Novus facilities. At some point, Harris realized he could get around Medicare’s limit on patients by enrolling first-time hospice patients.
This led him to work with a company called Express Medical to access confidential patient information so that he and his wife could recruit them for Novus hospice services, even if they weren’t eligible. Express Medical was used for laboratory services and home health visits. Harris testified against Gibbs and Hirjee, who decided to go to trial.
Harris received more than 13 years in prison for one count of conspiracy to commit healthcare fraud and one count of healthcare fraud and aiding and abetting. Gibbs was convicted at trial of one count of conspiracy to commit healthcare fraud, two counts of healthcare fraud, and one count of conspiracy to obstruct justice and received 13 years in federal prison. Medical director Hirjee was convicted at trial of one count of conspiracy to commit healthcare fraud, three counts of healthcare fraud, and one count of unlawful distribution of a controlled substance and received 10 years in prison.
Others convicted in the scheme include the following from the release:
- Sam Anderson, Novus VP of Marketing, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 33 months in federal prison
- Patricia Armstrong, Novus triage nurse, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 84 months in federal prison
- Slade Brown, Novus Director of Marketing, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 48 months in federal prison
- Amy Harris, Novus VP of Patient Services and wife of Bradley Harris, pleaded guilty to one count of conspiracy to obstruct justice and was sentenced to 38 months in federal prison
- Dr. Charles Leach, Novus Medical Director, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 57 months in federal prison
- Tammie Little, Novus Registered Nurse, was convicted at trial of one count of conspiracy to commit healthcare fraud and three counts of healthcare fraud and aiding and abetting and was sentenced to 33 months in federal prison
- Jessica Love, Novus Registered Nurse, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 102 months in federal prison
- Melanie Murphey, Novus Director of Operations, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 66 months in federal prison
- Ali Rizvi, Express Medical owner, pleaded guilty to one count of wrongful use of individually identifiable heath information and was sentenced to 18 months in federal prison
- Taryn Stuart, Novus Licensed Vocational Nurse, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 96 months in federal prison
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