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Business Owner, Doctor Sentenced for Roles in $34 Million Medicare Fraud Scheme

Posted on October 19, 2016

LOUISIANA


A federal judge sentenced the owner of a New Orleans medical service company and a doctor who served as the company’s Courtroommedical director to prison Wednesday for their involvement in a $34 million Medicare fraud scheme, according to authorities.

Elaine Davis, 60, of New Orleans, and Pramela Ganji, M.D., 67, of Harahan, Louisiana, were sentenced to eight years and  six years in prison, respectively.

U.S. District Judge Kurt D. Engelhardt of Louisiana imposed the sentences and scheduled a hearing to determine restitution owed by both defendants for Dec. 7, 2016.

On March 17, 2016, a jury convicted Davis and Ganji each of one count of conspiracy to commit health care fraud and one count of health care fraud.

According to evidence introduced at trial, Davis directed a massive fraud scheme through Christian Home Health Inc., a company that used elderly and disabled Medicare recipients in New Orleans and adjacent communities to fraudulently bill Medicare for purported home health care services.

Ganji served as Christian’s medical director from 2010 through 2015. 

Evidence showed that the vast majority of these patients did not require home health care services, and that Ganji falsely claimed that beneficiaries she had never examined were qualified to receive these services, according to officials.

The evidence indicated that Davis and Ganji caused Christian to bill Medicare for more than $34.4 million in claims, a vast percentage of which were fraudulent. 

Medicare paid more than $29.6 million on these claims.

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