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Houston Ambulance Operator Sentenced to Eight Years for $2.4 Million Health Care Fraud

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published June 16, 2014

By Author - LawCrossing

Gwendolyn Climmons-Johnson, 54, owner and operator of a Houston area ambulance company was sentenced on Friday to 97 months in prison for her role in a $2.4 million Medicare fraud scheme. She had been convicted by a federal jury in Houston last year of one count of conspiracy to commit health care fraud and four counts of health care fraud. In addition to her prison sentence, Climmons-Johnson will also have to serve three years of supervised release. She has been ordered to pay $972,132 in restitution.

The case was investigated by the FBI, HHS-OIG and Texas MFCU and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Southern District of Texas. The case was prosecuted by Trial Attorney Christopher Cestaro and Assistant Chief Laura M.K. Cordova of the Fraud Section.

According to evidence presented at trial, Climmons-Johnson was the owner and operator of Urgent Response EMS, a Texas-based entity that purportedly provided non-emergency ambulance services to Medicare beneficiaries in the Houston area.

From January 2010 through December 2011, Climmons-Johnson and others submitted false and fraudulent claims to Medicare for ambulance services that were medically unnecessary and/or not provided. Climmons-Johnson, who controlled the day-to-day operations of Urgent Response, submitted, and caused to be submitted, approximately $2.4 million in fraudulent ambulance service claims to Medicare.

Evidence found at the trial proved that patient records had been falsified and the Medicare beneficiaries for whom Climmons-Johnson had billed ambulance services did not actually need such services and were not in the condition claimed in the billing records.

The news was announced by Assistant Attorney General Leslie R. Caldwell of the Justice Department's Criminal Division and the and the Texas Attorney General's Medicaid Fraud Control Unit (MFCU).

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