Dr. Donald Gibson, II, 56, of Sugarland, Texas, and Sunday Joseph Edem, 53, of
Richmond, Texas, have been arrested for health care fraud and conspiracy to
commit health care fraud relating
medically unnecessary diagnostic testing and physical therapy, United States
Attorney Kenneth Magidson announced.
Both defendants were arrested without incident this morning and are expected
to make an initial appearance before U.S. Magistrate Judge Mary
Milloy.
According to the indictment, returned Thursday, May 17, 2012, and unsealed
today upon their arrests, Gibson ordered, prescribed, and authorized medically
unnecessary diagnostic tests and other procedures, which included allergy tests,
pulmonary function tests, vestibular tests, urodynamic tests, and physical
therapy, among others. These services were then billed to Medicare and Medicaid
for payment under Gibson’s billing number.
From January 2007 through January 2012, Gibson allegedly caused more than
$19.4 million in medical claims to the Medicare and Texas Medicaid Programs. As
a result, Medicare deposited approximately $8.5 million into a bank account
owned and controlled by Gibson.
The indictment also alleges Edem operated medical clinics under the names of
other individuals to conceal his financial interest in the businesses. Edem and
Gibson allegedly conspired with one another to cause the submission of false
claims to the Medicare and Medicaid programs and share in the proceeds. Gibson
and Edem paid patient recruiters for referring Medicare/Medicaid beneficiaries,
according to the indictment, and also paid Medicare beneficiaries for showing up
at the medical clinics.
This case is the result of a joint investigation involving multiple federal
and state agencies, including agents and investigators of the Railroad
Retirement Board, Secret Service, Drug Enforcement Administration, FBI, the Texas Attorney General’s Medicaid
Fraud Control Unit, and U.S. Department of Health and Human Services-Office of
Inspector General. Special Assistant U.S. Attorney Justin Blan and Assistant
U.S. Attorney Andrew Leuchtmann are prosecuting this case.
An indictment is a formal accusation of criminal conduct, not evidence. A
defendant is presumed innocent unless convicted through due process of law.
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