U.S. District Judge Melinda Harmon appears to be on a mission to send a message to would-be Medicare frauds. Last week, the judge for the Southern District of Texas sentenced a woman with stage IV metastatic breast cancer, and 7-year old twin boys at home, to 75 years in federal prison. The sentence, which surpassed the previous record for a similar crime by 25 years, came after a jury found her guilty of orchestrating a $13 million home health Medicare fraud scheme. Marie Neba's husband, Ebong Tilong, pleaded guilty to the same charges and was sentenced to 80 years.
Tilong, however, disabled his ankle monitor and disappeared early in the morning of October 13, the day he was to be sentenced. Judge Harmon issued a warrant, designated him a fugitive, and sentenced him in absentia. Prosecutors had asked for 35 years for Ms. Neba, who pleaded not guilty and forced a trial. They expressed surprise that the judge would double their request, and that Tilong, who pleaded guilty, would receive an even longer sentence.
The case involved the co-owners of Fiango Home Healthcare Inc. near Houston. According to court documents, the couple paid bribes to Medicare beneficiaries and then created claims using their information though no services had been rendered. Tilong's record-setting sentence may have been high because he fled but Judge Harmon is not making comments to the press about her rationale for either sentence.
"I am not a heartless person. I think I am not. I hope I am not," Harmon told Neba before announcing the sentence. She imposed the maximum allowable sentence for each count and then ordered that they should be served consecutively. "That is just the way the law works," she added, even though a pair of U.S. Supreme Court decisions in December 2007 reaffirmed that federal sentencing guidelines are merely advisory.
Obliterating Previous Records
For comparison, Lawrence Duran, the owner of a Miami-area mental health care company, was sentenced to 50 years for orchestrating a $205 million Medicare scheme that defrauded vulnerable patients with dementia and substance abuse. A Detroit physician who administered chemotherapy to healthy patients, a man federal prosecutors then called the "most egregious fraudster in the history of this country," received 45 years.
According to court records, after Tilong failed to show up for his sentencing hearing in October, a pretrial services officer notified District Judge Melinda Harmon that the officer received a tamper alert on Tilong’s ankle monitor around 7:30 that morning. The officer had several calls made to Tilong's cell phone but none were answered.
Tilong's nine guilty pleas were to one count of conspiracy to commit health care fraud, three counts of health care fraud, one count of conspiracy to pay and receive health care kickbacks, three counts of payment and receipt of health care kickbacks and one count of conspiracy to launder monetary instruments. In a separate but related case, he pleaded guilty to two counts of making and subscribing false statements.
Neba's case, though related, was distinct in that she was perceived as the organizer of the scheme that extended to at least five other people. Court documents cite:
Quoted in The National Law Journal, Patrick Souter, of counsel at Gray Reed & McGraw in Dallas and a professor who teaches health care fraud and abuse at Baylor Law School, said the prison term is unusually high "even for Texas" with its reputation for handing out tough sentences. But such an anomaly may not be one for long, at least in his state, he added.
"We’re seeing more health care fraud enforcement out there now than we’ve seen in the past. With these types of prosecutions and verdicts, we may start seeing more and more sentences closer to the [statutory] maximum, or at least significant sentences, because of the serious nature of the crime."
Neba's attorney Michael Khouri has filed an appeal challenging how the sentencing guideline range was calculated and arguing, among other matters, that the sentence is excessive.
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