A former owner of an Arkansas hospice, charged with state Medicaid fraud, has pleaded guilty to federal Medicaid-fraud charges in her home state of Mississippi.
A top federal investigator described Charline Brandon's fraud scheme as one of the largest and worst he's seen in Mississippi.
Brandon, 62, is accused of fraudulently billing the Arkansas program almost $290,000 in services to patients who were not terminally ill. The Cleveland, Miss., woman and her son owned Bridge of Faith Hospice and Palliative Care in Helena-West Helena. The facility has since been sold.
Brandon pleaded guilty earlier in the month in Mississippi to one count of conspiracy to commit health care fraud for her role in collecting Medicare and Medicaid payments from the U.S. Department of Health and Human Services and the Mississippi Medicaid program.
Prosecutors dropped eight counts of health care fraud in exchange for her guilty plea. She faces a maximum penalty of 10 years in prison when she is sentenced in January. In a news release, federal prosecutors said Brandon submitted more than $11 million in fraudulent claims to Medicare and more than $2 million to Medicaid.
Brandon owned and ran hospice programs in Cleveland, Miss., including Haven Hospice, North Haven Hospice, Lion Hospice and North Lion Hospice. In her plea, Brandon admitted that she fraudulently submitted claims to Medicare and Medicaid for hospice services that were not medically necessary or that were not provided to the hospice patients as claimed. She also admitted that she illegally recruited patients who were not hospice eligible.
"This sham hospice provider exploited the most vulnerable in our society while stealing millions from our health care system," Derrick Jackson, a chief Health and Human Services investigator from Atlanta, said in a news release. "This is one of the largest and most egregious hospice schemes I have seen in Mississippi."
Brandon, her son Wendell Brandon, Annette Lofton and Scott Nelson were indicted together in November last year. The charging documents describe Wendell Brandon as the owner of four of the clinics while Lofton owned and ran another clinic.
The indictment states that Charline Brandon submitted $31.8 million in Medicare reimbursement claims from one hospice between January 2005 and March 2011, and that she and her son, through four other programs, together submitted another $11.9 million in Medicare claims between September 2010 and March 2015, along with$2.9 million in Medicaid funds
According to the indictment, Nelson, a medical doctor, was medical director for seven clinics in Cleveland, Miss., where between January 2005 and June 2015, he falsely certified patients as terminally ill and qualified for $16.2 million in Medicare hospice funds, according to the indictment.
In Pulaski County Circuit Court, Charline Brandon, Pearlie Bailey, 64, of Mississippi, along with Clotee Downs, 80, of Mississippi, Debra Irby Stewart, 60, of Helena-West Helena, and Thomas Odell Bailey, 53, of Lexa, are charged with engaging in a continuing criminal enterprise and Medicaid fraud for activities said to have occurred between March 2011 and January 2017. Their trials have not yet been scheduled.
According to affidavits by an investigator with the Arkansas attorney general's office, the hospice billed Arkansas' Medicaid program for $289,986.46 for services provided to two patients who were not terminally ill.
One patient was listed by the hospice as receiving services for six years, with bills totaling $196,833.24.
The hospice's records falsely listed the patient as having a terminal diagnosis of lung disease, stroke, end-stage heart disease and congestive heart failure, the investigator wrote. Records from other medical care providers indicated the patient was not terminally ill, according to the document.
When told by an investigator that the hospice's records listed the patient as terminally ill, the patient "started crying and said she did not know that, and that no one had ever told her they thought she was terminally ill," the investigator wrote.
The payments received by the hospice in connection with the other patient, who was falsely listed as being diagnosed with lung disease and congestive heart failure, totaled $93,153.22, the investigator wrote.
That patient also "did not receive any meaningful services of the kind normally appropriate for hospice care patients," according to the affidavit.
Federal officials suspended Medicare payments to the hospice in May 2016, and Arkansas suspended Medicaid payments to the facility in March 2017, according to the affidavit.
Both patients "never received any medically necessary services from Bridge of Faith," the investigator wrote.
The hospice also submitted bills for nearly $60,000 in connection with a third patient "believed to be ineligible for hospice care," the investigator wrote.
Court records show Charline Brandon uses the alias Hadiya Imani El Bey while Wendell Brandon is also known as Omari Ibrahim El Bey.
Metro on 10/25/2018