The owner of one of the largest hospice providers in North Texas, his wife and 14 other individuals were indicted this week on charges related to their alleged participation in a health care fraud scheme that clearly put profits over the health and well-being of patients.
Novus Health Services was a for-profit hospice company owned and operated by Bradley J. Harris of Frisco, Texas. His wife, Amy L. Harris, was the co-founder and worked as vice president of patient services.
The other defendants charged in the indictment include Melanie L. Murphey, 35, of Fort Worth, Texas; Patricia B. Armstrong, 33, of Coppell, Texas; Mark E. Gibbs, 46, of Lindsay, Texas; Laila N. Hirjee, 50, of Plano, Texas; Syed M. Aziz, 51, of Frisco, Texas; Reziuddin Siddique, 63, of Allen, Texas; Charles R. Leach, 64, of Arlington, Texas; Jessica J. Love, 37, of Gainesville, Texas; Ali Rizvi, 49, of Carrollton, Texas; Tammie L. Little, 55, of Brashear, Texas; Mary Jaclyn Pannell, 29, of Krum, Texas; Taryn E. Stuart, 32, of Sanger, Texas; Slade C. Brown, 47, of Plano, Texas; and Samuel D. Anderson, 35, of Carrollton, Texas.
All of the defendants in the Novus health care fraud indictment were charged with one count of conspiracy to commit health care fraud. Twelve of the defendants have also been charged with at least one other count related to the alleged hospice fraud scheme.
The indictment claims that between July 2012 and September 2016, Novus billed Medicare and Medicaid for more than $60 million in fraudulent hospice services, of which more than $35 million was paid to Novus.
The defendants allegedly violated the False Claims Act by improperly placing patients in continuous care—the most expensive category of hospice services. They are also accused of recruiting ineligible hospice beneficiaries by providing kickbacks to referring physicians and healthcare facilities, and falsifying and destroying documents to conceal their activities from government health care agencies.
The allegations cited in the Novus health care fraud indictment include the following:
- Licensed physicians who were paid as Novus medical directors provided little or no oversight of Novus’s hospice patients. Patient care was allegedly directed primarily by Novus nurses and by Harris himself. Harris was a certified public accountant and did not hold a medical license, according to the indictment.
- The defendants, who were not physicians, were allegedly empowered to determine whether a patient should be certified for, re-certified for, or discharged from hospice. These individuals could also decide whether patients were placed on continuous care, and how and to what extent patients could be medicated with drugs such as morphine and hydromorphone.
- These critical medicalcare decisions were often motivated by profit rather than patient need. The defendants allegedly decided whether to place, keep, or discharge beneficiaries from hospice based on how much Novus could bill Medicare and Medicaid for the services.
- Novus targeted and recruited doctors who would refer hospice patients in exchange for kickbacks disguised as medical director salaries. In an email cited in the indictment, one of the defendants said: “My goal was to send as much business to Brad and Amy in return for directorships, etc.”
- Novus medical directors signed certificates of terminal illness indicating that beneficiaries were eligible for hospice services regardless of whether or not this was true; prepared re-certifications of terminal illness for beneficiaries already on hospice (thus falsely indicating that beneficiaries continued to be eligible for hospice care); and routinely provided their medical director login information so that others could log into Novus’s electronic medical records database and forge physician orders for health care services that were either never performed or were not performed by Novus medical directors. In one startling example cited in the indictment, a defendant signed for re-certification visits in Texas on days in which she was in Hawaii and Mexico.
- Novus provided assisted living facilities with remuneration in exchange for patient referrals.
- Bradley Harris allegedly directed beneficiaries to be placed on continuous care even when this level of care wasn’t medically necessary. When making this decision, Harris often failed to consult with a physician. The continuous care physician’s orders were allegedly falsified and entered into Novus’s electronic medical records database.
- When a beneficiary was on continuous care, Novus nurses (not doctors) would often administer high doses of Schedule II controlled drugs like morphine, whether beneficiaries needed the medication or not. Novus obtained the Schedule II medications were obtained through “C2” prescription forms that were pre-signed by medical directors. Pre-signing C2 prescription forms is against the law.
- Perhaps the most egregious allegation contained in the indictment is that Harris aggressively medicated patients to “ensure that the beneficiaries’ medical records contained documentation that would justify billing Medicare at the higher continuous care billing rate.”
The Novus health care fraud indictment contains allegations. The defendants are presumed innocent unless and until proven guilty in a court of law. If convicted, each count carries a maximum statutory penalty of 10 years in federal prison and a $250,000 fine.