An attorney in Grand Prairie, Texas, has been sentenced to 120 months in federal prison and ordered to pay $26,572,458.93 in restitution for his role in a workers’ compensation fraud scheme.
Federal prosecutors say that from July 2011 to September 2015, Tshombe Anderson and members of his family ran the scheme to fraudulently obtain more than $26 million from the Department of Labor (DOL) Office of Worker’s Compensation Program (OWCP).
The sentencing was announced by U.S. Attorney Erin Nealy Cox of the Northern District of Texas.
Anderson pleaded guilty in August 2017 to one count of conspiracy to commit health care fraud. Anderson agreed to forfeit $375,000 seized from his residence, a 2015 Mercedes, and his share of the $8,383,075 that was seized from 25 bank accounts. Anderson has been in custody since the time of his arrest in August 2015.
Anderson’s sister Lydia Bankhead, 63, his wife Brenda Anderson, 47, and his niece Lydia Taylor, 30, were also charged in the indictment returned in September 2015 and pleaded guilty to their roles in the scheme.
“Tshombe Anderson and others conspired to defraud the U.S. Department of Labor’s Office of Workers’ Compensation Programs (OWCP) of more than $26 million. Anderson stole patient information from over 200 injured federal workers and then used the information to fraudulently bill OWCP, enriching himself and others with taxpayer dollars intended for the treatment of injured federal workers,” Steven Grell, special agent in-charge of the Dallas Regional Office of the U.S. Department of Labor, Office of Inspector General, said in a statement.
According to plea documents in the case, Tshombe Anderson worked as an attorney for Union Treatment Centers (UTC).
Anderson and his wife, Brenda Anderson, opened a durable medical equipment company called Best First Administration (BFA). BFA was formed, initially, to provide durable medical equipment to patients referred to BFA from UTC. In July 2011, Tshombe Anderson and Brenda Anderson disassociated from UTC.
In April 2013, Tshombe Anderson agreed with Bankhead to open Union Medical Supplies and Equipment (UMSE). In August 2013, Tshombe Anderson opened Skycare Medical Supplies and Equipment (SMSE).
Both companies were created in order to submit claims that were inappropriate to OWCP. The same medical information that BFA had received from UTC was used and billed to the same universe of claimants for duplicate, unwanted durable medical equipment that was not medically necessary, using outdated medical information. Tshombe Anderson continued to do so despite knowing that they were billing OWCP for items that were not associated with the claimant’s injuries and that claimants were often refusing or rejecting the durable medical equipment for which their company had billed.
Tshombe Anderson had access to the operating accounts for UMSE and routinely transferred large sums of cash from those accounts for his personal use or to launder through business accounts for a shell company called American Federal Union Claims Advocates, as well as accounts associated with his law office.
The total amount paid to OWCP for UMSE and SMSE was $26,572,458.93.
The DOL Office of Inspector General and the U.S. Postal Service Office of Inspector General investigated the case. Assistant U.S. Attorneys Nicole Dana and P.J. Meitl prosecuted.
Source: U.S. Attorney’s Office for the Northern District of Texas
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