Former BESE member faces charges in sweeping crackdown on Medicare fraud _lowres

Advocate staff photo by DANIEL ERATH -- Louella Givens poses a question to Congressman Cedric L. Richmond and House Democratic Leader Nancy Pelosi during a forum entitled “When Women Succeed, America Succeeds: An Economic Agenda for Women and Families” at Tulane University on Sunday September 21, 2014.

Federal prosecutors have charged a former member of the Louisiana Board of Elementary and Secondary Education as part of a nationwide crackdown on Medicare fraud.

Louella Givens, an outspoken and at times feisty board member who represented the New Orleans area on BESE for two terms before losing her re-election bid in 2011, is accused of submitting millions of dollars in fraudulent Medicare claims through her home health care companies.

Ten other people, including two doctors and a psychologist, were charged in five separate New Orleans-based schemes that the authorities said involved about $110 million in fraudulent Medicare claims.

The New Orleans charges were part of a nationwide health care fraud sweep that led to charges against 243 people, including doctors, nurses and pharmacy owners accused of bilking Medicare and Medicaid, the government announced Thursday.

The dragnet spread from Miami to Los Angeles and from Dallas to Brooklyn, New York. Combining all the cases, allegedly fraudulent billings totaled $712 million.

U.S. Attorney General Loretta Lynch referred to the bust as “the largest criminal health care fraud takedown in the history of the Department of Justice.”

Givens could not be reached for comment Friday. She is scheduled to appear in federal court June 30.

As owner of Maxima Home Health Services and another company known as House Call Home Health Care, Givens paid kickbacks for patient referrals and submitted claims to Medicare for services that either weren’t provided or were not medically necessary, according to a 26-page criminal complaint filed in U.S. District Court.

Federal authorities began investigating Maxima about a year ago after a confidential informant told them that Givens had been paying people for referrals for home health care services and “billing Medicare services that were not medically necessary and/or not provided,” the complaint says.

After reviewing bank records and Medicare claims data and interviewing former employees, the authorities determined many of the beneficiaries involved had not met Medicare criteria for home health care. For starters, the complaint says, many of the patients weren’t homebound.

“The information obtained by investigators also indicated that many of these same beneficiaries reported never having seen or (having) any contact with the physician listed on Maxima billing documents as the referring physician,” Wesley Root, a special agent with the U.S. Department of Health and Human Services Office of Inspector General, wrote in the complaint.

Givens was no stranger to controversy during her time on the state’s top school board. In 2011, The Times-Picayune reported she had been arrested for DWI after drinking cocktails at Sweet Lorraine’s Jazz Club on St. Claude Avenue. Later that year, the newspaper reported that the Internal Revenue Service had placed a lien on Givens’ home due to more than $1.3 million unpaid federal taxes.

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