4 New Orleans doctors, 2 others convicted in $13.6 million Medicare fraud scheme – NOLA.com

A jury convicted four New Orleans doctors and two others on Tuesday (May 9) in federal court for participating in a Medicare fraud scheme prosecutors say netted more than $13.6 million in fraudulent Medicare reimbursements.

The six defendants, all from the New Orleans area, worked for or with Abide Home Care Services, which federal prosecutors said routinely falsified diagnoses so Medicare reimbursements were inflated. Abide also falsified medical records that supported medically unnecessary home health services, prosecutors said. The company was owned by New Orleans businesswoman Lisa Crinel, who pleaded guilty to her role in the scheme in 2015. Eighteen other individuals or companies also previously pleaded guilty related to the scheme.

Tuesday’s guilty verdicts came after a month-long trial, a press release from Acting U.S. Attorney Duane Evans’s Office says. Found guilty were Dr. Henry Evans, 71; Dr. Michael Jones, 47, and his wife Paula Jones, 45; Dr. Shelton Barnes, 62; Dr. Gregory Molden, 60, all of New Orleans; and Jonathon Nora, 29, of River Ridge.

The U.S. Attorneys Office said all four doctors, known as “home doctors,” ordered home health care service for Medicare beneficiaries “who had no legitimate necessity,” then falsely signed medical orders.  

In exchange for their role in the scheme, Abide made monthly payments to Drs. Shelton Barnes, Henry Evans and Molden that were “fraudulently characterized as medical consultant or director fees,” though no actual consulting services were provided. Rather than receive the monthly payments directly, Abide hired Dr. Michael Jones’ wife Paula Jones and “inflated salary payments to her to pay Michael Jones” for fraudulently certifying documents, according to the U.S. Attorneys Office. 

Paula Jones fraudulently billed Medicare on behalf of Abide for medically unnecessary home health services, prosecutors said. Nora scheduled doctor visits with Abide doctors “well knowing” that the referral did not come from the beneficiary’s own health care professional.

Evans was found guilty of five counts of health care fraud. Michael Jones, Paula Jones, Barnes, Molden and Nora each were found guilty of conspiracies to commit health care fraud and to defraud the United States and to receive and pay health care kickbacks and of health care fraud, according to the U.S. Attorneys Office. The four doctors and Nora were convicted of additional individual counts of health care fraud. Dr. Shelton Barnes was additionally convicted of obstruction of a federal audit. 

Barnes faces a maximum penalty of up to 170 years in federal prison; Molden faces up to 115 years; Dr. Michael Jones faces up to 95 years; Evans faces up to 50 years in federal prison; Paula Jones faces up to 15 years; and Nora faces up to 25 years. Each also faces a maximum fine of up to $250,000 for each count. 

NOLA.com | The Times-Picayune’s Heather Nolan contributed to this report.

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