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Owner of Houston Health Care Company Convicted of Defrauding Medicare

Texas Business reports:  HOUSTON—An owner of a Houston health care company was convicted yesterday by a jury in the Southern District of Texas in connection with a $750,000 Medicare fraud scheme, announced the Departments of Justice and Health and Human Services (HHS).

Philip Ware, 31, of Houston, was convicted of one count of conspiracy to commit health care fraud and four counts of substantive health care fraud.

The evidence presented at trial showed that Ware was an owner and operator of Preferred Plus Medical Supply. Preferred Plus maintained a valid Medicare provider number in order to submit Medicare claims for the costs of durable medical equipment (DME) and purported to provide orthotics and other DME to Medicare beneficiaries.

Preferred Plus submitted claims to Medicare for DME, including orthotic devices, which were medically unnecessary and/or not provided. Many of the orthotic devices were components of “arthritis kits” and purported to be for the treatment of arthritis-related conditions; however, the devices were neither medically necessary nor appropriate for such conditions.

The arthritis kit generally contained a number of orthotic devices including braces for both sides of the body and related accessories such as heat pads. In total, from August 2008 through July 2009, Preferred Plus submitted approximately $750,000 in fraudulent claims to Medicare.

At sentencing, scheduled for September 24, 2012, Ware faces a maximum sentence of 50 years in prison.

Ware’s co-owner of Preferred Plus, Simone Ball, previously pleaded guilty to one count of conspiracy to commit health care fraud. Ball’s sentencing is scheduled for August 8, 2012.

The conviction was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Southern District of Texas Kenneth Magidson; Texas Attorney General Greg Abbott; Acting Special Agent in Charge Russell D. Robinson of the FBI’s Houston Field Office; and Special Agent in Charge Mike Fields of the Dallas Regional Office of HHS Office of Inspector General (HHS-OIG), Office of Investigations.

This case was prosecuted by Trial Attorneys David Maria, Ben O’Neil, and Laura M.K. Cordova of the Fraud Section in the Justice Department’s Criminal Division. The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section.