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

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

The owner of a New Orleans medical service company and a doctor who served as the company’s medical director were sentenced to prison today for their involvement in a $34 million Medicare fraud scheme.

Elaine Davis, 60, of New Orleans, and Pramela Ganji, M.D., 67, of Harahan, Louisiana, were sentenced to 96 months and 72 months in prison, respectively.   The sentences and hearing is scheduled for Dec. 7, 2016, to determine restitution owed by both defendants.  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. (Christian), 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 presented at trial 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.

The evidence at trial demonstrated 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.