Kenric Wakeen Griffin, co-owner of Frisco-based New Horizons Durable Medical Equipment, was sentenced to four years of prison, followed by a year of supervised release for his role in a medical equipment fraud scheme.
Griffin was also mandated to provide restitution totaling $5,114,016.19 to government health care programs. The jury found Griffin guilty of conspiracy to defraud the U.S. and engaging in the exchange of healthcare kickbacks, along with seven counts of receiving and making kickback payments.
“Griffin obtained patients by offering and paying kickbacks to marketers as well as disguising illegal payments as marketing services and outsourced business services,” the office of the Texas Attorney General said in an official statement. “Griffin then submitted false claims to both Medicaid and Medicare for orthopedic equipment that was never provided, not medically necessary and not authorized by a physician.”
Sergeant Doug Wood, Investigative Auditor Jennifer Blakely and Captain Justin Boyce from the Texas Medicaid Fraud Control Unit ("MFCU") spearheaded the investigation, collaborating with the Federal Bureau of Investigation and the U.S. Department of Health and Human Services Office of Inspector General. The Department of Justice Health Care Fraud Strike Force handled the prosecution of the case.
In the previous fiscal year, the MFCU successfully obtained settlements and judgments amounting to over $236 million. Considering that Medicaid expenses amount to more than $40 billion annually in the state, federal and industry experts estimate that fraud may account for up to 10% of the program's costs, translating to a $4 billion issue related to Medicaid fraud in Texas.
For 2023, the MFCU secured a grant award amounting to $20,944,200 from the U.S. Department of Health and Human Services, covering 75% of its funding. The state of Texas contributes the remaining 25%. For every dollar invested by the state, the OAG's MFCU generates a recovery of more than $33, benefiting taxpayers.
If you suspect any instances of Medicaid fraud, abuse or patient neglect, report it through the OAG's website.
