On April 24th, two brothers were sentenced to more than four years in federal prison for their convictions of conspiracy to commit health care fraud, health care fraud and money laundering. Kevin Olufemi Davies, 29, and his brother Melvin Olusola Davies, 28, who pled guilty in Dec. 2016, received their sentences. U.S. District Judge Lynn Hughes ordered Kevin to serve a 57-month sentence, while his brother received 63 months in federal prison. Both will also be required to serve three years of supervised release following completion of the prison term. They were further ordered to pay a more than $2.3 million in restitution.
The defendants owned and operated KMD Healthcare Services Inc. (KMD) from their home in a gated townhouse community in Houston. The brothers admitted they submitted approximately $6 million in false and fraudulent claims to Medicare, Medicaid and Tricare (another government health program) for ambulance services that were not provided. The brothers admitted they transported Medicare beneficiaries with only one of the two required EMTs and in vans instead of ambulances. They also admitted they paid a Houston physician $500 for certificates of medical necessity and paid some of the Medicare beneficiaries to ride in the vans.
Medicare, Medicaid and Tricare only pay for medically necessary ambulance services in vehicles designed and equipped to respond to medical emergencies and for patients who cannot be safely transported by any other means of transportation. Medicare also requires two individuals to staff ambulance transports, including at least one licensed EMT.
According to the plea agreements, the EMTs working for the defendants wrote up ambulance “run sheets” even though the Medicare beneficiaries did not travel by ambulance and did not need ambulance services. The individuals transported were not bed bound, could walk and routinely used non-ambulance transport in their daily activities. Apparently, one patient even walked to her own therapy session. KMD billed Medicare $51,952 for her ambulance transportation.