Houston Medicaid Billing Scheme Fueled $16M in Alleged False Mental Health Claims

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"Federal authorities say they have launched the largest health care fraud crackdown in U.S. history, charging hundreds of defendants and alleging billions of dollars in false claims — including multiple cases tied to the Houston area.

The Justice Department said 455 defendants are accused of schemes involving more than $6.5 billion in false claims tied to taxpayer-funded programs.

In Southeast Texas, prosecutors highlighted several cases centered in the Houston area. In one scheme, prosecutors said a Houston-area operation billed more than $16 million to Texas Medicaid for mental health services that often were not provided or were not provided by properly licensed professionals.

In another case, a Texas defendant allegedly collected $3 million by billing for physical therapy while patients watched TV, used their smartphones or exercised on their own.

Federal prosecutors also charged three people in what they described as a Houston-area “pill mill,” alleging cash-only clinics and a Conroe pharmacy helped distribute more than 3 million pills, including oxycodone and hydrocodone.

The largest case mentioned in the region involves nurse practitioner Marcelle Yuki. The DOJ alleged she generated more than $906 million in false Medicare and Tricare claims by targeting elderly patients, including some in hospice.

Authorities also detailed high-dollar assets tied to the investigation, including a $594,000 Ferrari that was purchased and one of eight seized vehicles, an $865,000 Bulgari necklace, a $4.6 million beach resort in the Philippines, and a $3 million certificate of deposit.

Officials said the alleged schemes targeted American taxpayers and the government programs they fund, including Medicare and Medicaid."