Thursday, December 9, 2021

Medical Directors Sentenced

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Judge Lynn

By Jim Parker

Chief U.S. District Judge Barbara M.G. Lynn has sentenced Novus Health Services Medical Directors Mark E. Gibbs, M.D., and Laila Hirjee, M.D., along with one of the company’s nurses, Tammie Little, to a combined 23 years in prison following their convictions for hospice fraud exceeding $40 million.

Gibbs was sentenced to 13 years as well as paying restitution of nearly $28 million. Hirjee received 10 years in prison and must pay more than $16 million. The judge also sentenced Little to a 33 month incarceration.

The company’s CEO Bradley Harris was also convicted in the case. He agreed to a plea deal, pled guilty and testified against his former employees, according to the U.S. Department of Justice.

“These doctors allowed Bradley Harris – an accountant with no medical expertise – to dispense controlled substances like candy, with little to no medical oversight,” said U.S. Attorney Chad Meacham. “They claimed to have had hands-on experience with hospice patients, when in fact, they’d entrusted life-or-death medical decisions to untrained businesspeople. We are satisfied to know they will spend the next decade behind bars.”

Prosecutors accused Gibbs, Hirjee and Little of helping Harris defraud Medicare by submitting materially false claims for hospice services, providing kickbacks for referrals, violating HIPAA to recruit beneficiaries, and destroying documents to conceal the evidence.

In addition to the conspiracy charge, Gibbs was convicted of two counts of health care fraud and one count of obstruction of justice. Likewise, Hirjee received a guilty verdict for three counts of fraud and one drug offense. The physicians allegedly left blank, signed prescription pads that Harris used to provide controlled substances to patients, even though he is not a physician or licensed independent practitioner, according to the Justice Department. Little was found guilty of three fraud counts.

Gibbs was acquitted of a third fraud charge despite being convicted for the other two.

During his own trial, Harris admitted to knowingly exceeding the Medicare aggregate hospice cap in 2014 by enrolling an influx of patients and negotiating an agreement with vendor Express Medical Supply that gave him access to confidential patient medical information in exchange for using the company’s laboratory services and home health visits.

Harris’ wife and other Novus staff contacted individuals with this information to bring them on as hospice patients, regardless of whether they were eligible to receive the benefit or needed end-of-life care, the Justice Department indicated.

Harris testified that he and Little, rather than physicians, decided which patients would be admitted to or discharged from the Novus hospice program and which drugs and dosages they would receive.

He further indicated that Novus doctors, including Gibbs and Hirjee, signed certification documents for patients without conducting the required face-to-face examination, according to the Justice Department. Harris said he paid those physicians kickbacks for enabling the fraud.

Novus Director of Operations Melanie Murphey was also involved in falsely certifying patients. “I was the doctor,” she testified at trial. A total of 14 Novus staff have been prosecuted for their roles in the scheme, as well as Ali Rizvi, the owner of a separate physician home visit company.

“The defendants violated their Hippocratic Oath as doctors and instead focused on lining their pockets at the expense of patient safety. This case highlights the importance of thoroughly investigating any complaint of health care fraud,” said FBI Dallas Special Agent in Charge Matthew DeSarno.