From the Department of Justice: Couple sentenced to prison for Medicare fraud
Date: August 4, 2017 | Category: News
We are sharing this news release from the Department of Justice. If you suspect Medicare abuse or fraud in Missouri, call the Missouri SMP at 888-515-6565.
DALLAS — A former employee at Parkland Health and Hospital System in Dallas (Parkland), Viju Mathew, and his wife, Mariamma Viju, a registered nurse who worked at Baylor University Medical at Dallas (Baylor), who pleaded guilty to federal charges stemming from their theft/unlawfully obtaining patient identification information, were sentenced today by U.S. District Judge Jane J. Boyle, announced U.S. Attorney John Parker of the Northern District of Texas.
Viju Mathew, 52, and his wife, Mariamma Viju, also 52, were sentenced to 30 months imprisonment and ordered to pay $297,957.89 in restitution to Medicare. Mathew pleaded guilty in November 2014 to one count of fraud and related activity in connection with identification documents, authentication features and information (identity theft) and Viju pleaded guilty in May 2016 to one count of wrongful disclosure of individually identifiable health information (HIPAA violation). Both defendants reside in Garland, Texas. Judge Boyle ordered they surrender to the Bureau of Prisons on August 30, 2017.
According to plea documents filed in the cases and the evidence produced during the sentencing hearing, which spanned four days, Mathew and Viju both stole patient identities from their jobs at local hospitals and used the stolen patient information to solicit patients for the home health care agency they jointly owned and operated, Dallas Home Health. Mathew worked as a registration specialist at Parkland, where he was responsible for entering patient information into Parkland's computer system. Mathew used his position to obtain confidential information for more than 3,000 patients, including patients' names, telephone numbers, dates of birth, participation in the Medicare program, and government-issued health insurance claim numbers. Mathew admitted that he knowingly removed the confidential information intending to use it to gain an economic benefit by contacting prospective patients for his home health care business, Dallas Home Health.
Viju worked as a registered nurse at Baylor until she was terminated in October 2012. While employed at Baylor, she surreptitiously collected Baylor patient identification information, specifically, identifying health information, to recruit them as patients of Dallas Home Health, where she served as Director of Nursing.
The evidence also showed that Dallas Home Health obtained patient certifications from a number of doctors who have been convicted or charged in other health care fraud cases in the Northern District of Texas including Nicholas Padron (Case No. 3:12-CR-310), Jacques Roy (3:12-CR-054-L), and Hector Molina (Case No. 3:15-CR-163-K).
The FBI, Department of Health and Human Services Office of Inspector General, and the Texas Attorney General's Medicaid Fraud Control Unit investigated. Assistant U.S. Attorney Doug Brasher prosecuted the cases.
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