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Document and Benefit Fraud

Local home health care agency owner sentenced to nearly 4 years in prison

DALLAS - The owner of a home health care agency was sentenced Thursday to 46 months in federal prison following her guilty plea in August 2008 to one count of mail fraud. The sentence was announced by acting U.S. Attorney James T. Jacks, Northern District of Texas; the case was investigated by: U.S. Department of Health and Human Services' Office of Inspector General (HHS-OIG), U.S. Immigration and Customs Enforcement (ICE), and the FBI.

Irene Anderson, 45, of Wylie, Texas, was sentenced by U.S. District Judge Jane J. Boyle. Anderson was also ordered to pay $2,276,622.31 restitution and forfeit a 2006 Hummer, a 2002 Suzuki and $8,500 in cash that was found in her car when she was arrested on April 18, 2008, in Wylie, Texas. She has been in custody since her arrest.

"Today, Ms. Anderson found what health care providers who defraud Medicare are finding all over America, you will be held accountable for your greed," said Mike Fields, special agent in charge, HHS-OIG. "HHS-OIG agents will continue to work closely with our State and Federal law enforcement partners to protect the Medicare Trust Fund," Fields continued.

According to documents filed in Court, since Sept. 25, 2001 Anderson operated AG Total Care Home Health Services Inc., aka AG Total Care Home Health Services Inc., in Dallas. She applied for and obtained a Medicare provider number for AG Total Care in February 2002, which was used to submit claims to Medicare and receive reimbursement for such claims.

In addition, since October 26, 2004, Anderson also owned and operated a second home health agency, New Dimension Healthcare Services in Sulphur Springs, Texas. Although Anderson was the true owner of New Dimension, she applied for an assumed-name certificate for New Dimension from the Dallas County Clerk's Office listing the name of the business as "Iya Edwards, dba [doing business as] New Dimension Healthcare Services" on the application. Anderson also misrepresented to New Dimension employees and others that "Iya Edwards" was the owner of New Dimension.

"Iya Edwards" was a completely fictitious identity created and used by Irene Anderson, for which Anderson obtained a Social Security number and Texas Driver's License, separate and distinct from her own driver's license and Social Security number. Federal agents determined that Irene Anderson and "Iya Edwards" were one and the same individual after comparing fingerprints taken from her on prior occasions using one identity or the other. Documents filed at sentencing show that in mid-2007, Anderson was in the process of securing yet another U.S. visa under a third identity, Irene Ekpe.

Beginning in February 2005 and continuing until May 2008, Anderson operated a scheme to defraud the U.S. Department of Health and Human Services and Medicare by applying for and obtaining a Medicare provider number for her home health agency, New Dimension, falsely representing that New Dimension was owned by "Iya E. Edwards."

Iya Edwards, dba New Dimension was issued a Medicare provider number in March 2005 and from about March 9, 2005 to April 21, 2008, Anderson billed Medicare for services using that number. Throughout this period, Anderson continued to falsely represent to Medicare that the owner of New Dimension was Iya Edwards rather than Anderson, causing Medicare to pay New Dimensions a total of $1,188,698.74 because of her scheme. Anderson also fraudulently obtained more than another $1 million in Medicare funds paid to AG Total Care for home health visits that Anderson never made. These payments are included in the Court's restitution order of $2.2 million.

"This conviction represents our continuing commitment to vigorously prosecute fraud in government health care programs," said Robert E. Casey Jr., special agent in charge of the FBI office in Dallas. "The FBI will not tolerate any health care providers that attempt to manipulate the Medicare program to fill their coffers at the taxpayers' expense. I would like to thank HHS-OIG and ICE for the expertise they brought to this investigation."

"This so-called health care worker misrepresented herself to fraudulently obtain immigration and government benefits," said John Chakwin, special agent in charge of the ICE Office of Investigations in Dallas. "ICE routinely and aggressively works with many agencies to help identify and pursue prosecution against these people, and especially those who compromise people's health." Chakwin oversees north Texas and the State of Oklahoma

Acting U.S. Attorney Jacks praised the excellent investigative work of the U.S. Department of Health and Human Services' Office of Inspector General, the FBI, and U.S. Immigration and Customs Enforcement.

Assistant U.S. Attorney Katherine Miller, Northern District of Texas, prosecuted the case.