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ETX couple indicted for conspiracy, health care fraud

ETX couple indicted for conspiracy, health care fraud
MGN-Online
CrimeWatch
Monday, August 5, 2013 - 12:42pm

U.S. Attorney John M. Bales announced that a Center, Texas couple, now living in Elgin, Texas, and a Center, Texas man have been indicted on charges of conspiracy and health care fraud in the Eastern District of Texas.

The former owners and operators of North East Texas EMS, Cathy Harvill, 56, and Bill Harvill, 59, and the former supervisor of the North East Texas EMS Nacogdoches office, Shon Cooper, 42, were indicted by a federal grand jury on July 24, 2013.

According to the indictment, from January 2007 through March 31, 2012, the defendants carried out a scheme to defraud Medicare and Medicaid through the submission of false and fraudulent claims for ambulance services which did not meet Medicare program coverage criteria. It is alleged that the defendants submitted or caused the submission of false and fraudulent claims of approximately $2,346,000 to Medicare and Medicaid for ambulance services which did not meet Medicare program coverage criteria and for which they were not entitled to reimbursement. Based on these false and fraudulent claims, reimbursement of approximately $787,000 was made by Medicare and Medicaid to North East Texas EMS. It is also alleged that the defendants instructed employees to omit information from ambulance service records and add information to ambulance service records in order to conceal the true conditions of the patients and to receive reimbursement from Medicare and Medicaid.

The Medicare Program (Medicare) is a health care benefit program which provides benefits to persons who are over the age of sixty-five and some persons under the age of sixty-five who are blind or disabled. The Texas Medical Assistance Program (Medicaid) is a health care benefit program, jointly funded by the State of Texas and the federal government, that helps pay for reasonable and necessary medical procedures and services provided to individuals who are deemed eligible under state low-income programs.

If convicted, the defendants face up to ten years in federal prison.

The investigation leading to the charges was conducted by agents from the United States Department of Health and Human Services – Office of the Inspector General (HHS-OIG) and the Texas Office of the Attorney General – Medicaid Fraud Control Unit (OAG-MFCU). Assistant United States Attorney Nathaniel C. Kummerfeld and Special Assistant United States Attorney Alma Hernandez are prosecuting this case.

An indictment is not evidence of guilt and all defendants are presumed innocent until convicted in a court of law.
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