Group Home Owners Convicted in $1M Fraud Scheme

A Texas couple who owned and operated group homes recently was found guilty of perpetrating a $1 million dollar scheme to defraud Medicare.

Lindell King, 52, and his wife Ynedra Diggs, 44 were charged with sending their group home residents to Behavioral Medicine of Houston (BMH), in exchange for kickbacks. BMH was a community mental health center that purportedly provided partial hospitalization services. The kickbacks were often concealed as payment for transportation and other “sham services,†according to the U.S. Department of Justice.

Over the course of the conspiracy, King and Diggs received payments for which BMH was paid approximately $1 million by Medicare. The couple was convicted of a conspiracy to defraud the U.S. and to pay and receive healthcare kickbacks and several violations of the Anti-Kickback statute. King faces up to 20 years in prison on all charges; Diggs faces up to 15 years. Sentencing is set for August 4.

The government has increasingly used the False Claims Act in the healthcare arena. As we wrote about in February, the U.S. Department of Justice reported taking in more than $5.6 billion in False Claims Act settlements and judgements in the fiscal year ending Sept. 30, 2021 – the second largest annual total FCA’s history and the largest in seven years.

Providers who file false claims may face fines of up to three times the programs’ loss plus $11,000 per claim filed. Under the civil FCA, each item or service billed to the federal government’s healthcare programs counts as a claim, so fines can quickly add up.

The Health Law Offices of Anthony C. Vitale represents clients under investigation by a wide range of state and federal agencies. Our firm will develop a defense case presentation to the prosecuting authority that is designed to mitigate criminal, civil or administrative liability. We will meet with the prosecutor to protect your interests.

It’s imperative that you reach out to a healthcare defense attorney as soon as you are contacted by an enforcement agency. Any mistakes you make at the start of an investigation may cost you a lot more in the end.  Give us a call at 305-358-4500 or email info@vitalehealthlaw.com.