Clinic Operators, Physician Found Guilty of Medicare Fraud

A federal jury this week found a physician and 2 clinic owners and operators guilty for their roles in a $17 million Medicare fraud scheme.

John P. Ramirez, MD, 64; Ann Nwoko Shepherd, 62; and Yvette Nwoko, 30, all of Houston, Texas, were convicted of one count of conspiracy to commit health care fraud after a 6-day trial, according to a press release from the US Department of Justice (DOJ). In addition, Nwoko was convicted of 3 counts of health care fraud, Shepherd was convicted of 6 counts of health care fraud and Ramirez was convicted of 3 counts of false statements relating to health care matters.

According to evidence presented at trial, from approximately December 2011 to August 2015, Ramirez, Shepherd and Nwoko conspired and schemed to defraud Medicare out of payments for medical services. Shepherd owned and operated Southwest Total Medical Inc., a purported medical clinic doing business as Amex Medical Clinic in Houston. Shepherd sold medical orders and other documents signed by Ramirez to home-health agencies in and around Houston. Ramirez falsely certified in these medical orders information about the patient’s medical condition and need for medical services, according to the release.

Co-conspirators at home-health agencies then used the false and fraudulent paperwork signed by Ramirez and sold by Shepherd to bill and receive payment from Medicare for medical services that were not medically necessary or not provided, DOJ officials explained. Later in the scheme, Nwoko acted as the manager of Amex Medical Clinic where she sold false and fraudulent paperwork used by co-conspirators to bill and receive payment from Medicare for similarly unnecessary medical services, the evidence showed. Shepherd also caused Amex Medical Clinic to bill Medicare for purported physician services that were actually provided by an unlicensed practitioner, if at all, the evidence showed.

The 3 caused Medicare to pay approximately $17 million on false and fraudulent claims submitted during the charged conspiracy, according to the statement.

This case was investigated by the FBI, HHS-OIG and the Texas Attorney General’s Medicaid Fraud Control Unit. Trial Attorney Scott Armstrong of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Tina Ansari of the Southern District of Texas are prosecuting the case.

Sentencing is scheduled for Dec. 12 before U.S. District Judge David Hittner of the Southern District of Texas, who presided over the trial.