On June 18, 2013, Julian Kimble was sentenced to 17 years in federal prison and ordered to pay $3,676,587 to the Medicare program as restitution following his 2011 convictions for conspiracy to commit health care fraud and other crimes.
In November 2011, Kimble pled guilty to conspiracy to commit healthcare fraud, money laundering, and tax evasion. Kimble admitted to owning four ambulance companies – Tamimi International Inc, Monarch Ambulance, HKO Group Inc, and Houston EMS – and that he frequently billed basic life support to Medicare for ambulance transports and services that were not medically necessary or not provided at all. Kimble and the other conspirators often transported multiple beneficiaries together in cars or vans, and then billed Medicare for individual transports in ambulances with trained emergency medical personnel.
Furthermore, Kimble received kickbacks from several owners of community mental health centers in exchange for transferring patients to their facilities. The patients also received payments in exchange for assenting to be transported to different facilities in the Houston area. In total, Kimble’s ambulance companies billed Medicare nearly $8.7 million and received over $3.6 million.
In an attempt to hide the profits of his fraud, Kimble withdrew funds from the accounts of his ambulance companies, used those funds to pay kickbacks to patients, and kept any remaining for himself. From the funds he fraudulently acquired from Medicare, Kimble paid his conspirators. Between August and December of 2010, Kimble’s conspirators received over $1 million in fraudulently acquired funds from Kimble, and none of it was reported as taxable income.
This case was investigated by the Internal Revenue Service – Criminal Investigations, the United States Secret Service, as well as the Department of Health and Human Services – Office of Inspector General (OIG). Furthermore, in the 2013 Workplan released by the OIG, the report indicated that the OIG would investigate the relationships between providers and ambulance companies, possibly in relation to the anti-kickback statute. Therefore, ambulance companies and suppliers should expect continued and possibly increased scrutiny on these issues. Ambulance companies should develop effective compliance programs to help assess their risk regarding these areas of scrutiny. If you or your healthcare entity would like assistance creating and implementing a compliance plan, or have other healthcare related questions, please contact an experienced healthcare attorney at 248-544-0888.