Thirteen defendants involved in the $27 million Novus healthcare fraud have been sentenced to a combined 84 years in federal prison. According to plea papers and evidence presented to a jury, Novus Health Services, a Dallas-based hospice agency, defrauded Medicare by submitting materially false claims for hospice services, providing kickbacks for referrals, and violating HIPAA to recruit beneficiaries. Novus employees also dispensed Schedule II controlled substances to patients without the guidance of medical professionals and moved patients to a new hospice company in order to avoid a Medicare suspension.
CEO Bradley J. Harris eventually admitted to the fraud and testified against two physicians who elected to proceed to trial. He told the jury that instead of relying on the expertise of licensed medical professionals, he and Novus’ nurses determined which medications and dosages patients would receive, dispensing drugs like morphine and hydrocodone using pre-signed prescription pads. Novus medical directors, including Dr. Mark Gibbs and Dr. Laila Hirjee, were supposed to oversee the care of these patients and examine patients face-to-face to certify that they were terminally ill. Often, however, the medical directors signed off on patient care plans without properly reviewing patients’ files and falsely certified they had completed in-person examinations when they had not.
