HOUSTON – A Humble resident has been convicted of conspiracy to commit health care fraud and money laundering.
Lawrence Tyler, 41, has been convicted seven counts of health care fraud and one count of money laundering after a five day trial, announced U.S. Attorney Kenneth Magidson for the Southern District of Texas.
Tyler, of Humble, ran a durable medical equipment company called 1866-ICPayday.com from 2006 to 2008.
The evidence at trial showed that between January 2007 and December 2008, Tyler engaged in a scheme to defraud Medicare and Medicaid. He falsely billed Medicare and Medicaid for so-called “ortho kits” which consisted of an assortment of various back, knee, ankle, wrist and shoulder braces.
Tyler allegedly billed for equipment that was never delivered, billed for equipment using prescriptions from a physician who never treated the patients and upcoded, which means he billed for a higher reimbursed brace but delivered a cheaper brace that either did not fit the billing code or did not qualify for any Medicare reimbursement.
Tyler submitted approximately $3 million in claims for durable medical equipment and was paid approximately $1.4 million by Medicare and Medicaid, according to a press release.
The evidence at trial also showed that Tyler paid kickbacks to a recruiter named Birdie Leroy Revis in exchange for beneficiary information and false prescriptions issued by Revis’ cousin, Dr. John Perry. Many of the beneficiaries testified that they did not know Perry and had never been treated by him.
Revis was convicted of illegally receiving kickbacks, while Perry was convicted of conspiracy to commit health care fraud in separate cases.
In addition, the evidence showed Tyler conducted a monetary transaction in criminally derived proceeds when he withdrew approximately $140,000 from Wachovia Bank. The monies were proven to be the proceeds of the health care fraud conspiracy.
Tyler faces up to five years in prison for the conspiracy as well as up to 10 years for each count of health care fraud and money laundering in addition to substantial fines.
The case was the result of a joint investigative effort of the Texas Attorney General's Medicaid Fraud Control Unit, the FBI, Department of Health and Human Services - Office of Inspector General, Office of Investigations and the U.S. Attorney’s Office.
Special Assistant United States Attorneys Suzanne Bradley and Adrienne E. Frazior prosecuted the case.