Date: 11-20-2015

Case Style: United States of America v. Jocelyn Pyles-Elo, M.D.

Case Number: 4:15-cr-00085

Judge: Not Available

Court: United States District Court for the Southern District of Texas (Harris County)

Plaintiff's Attorney: Julie Redlinger and Rodolfo Ramirez

Defendant's Attorney: Jim Gibbs

Description: Houston, TX - Jury Convicts Former City of Houston Doctor of Health Care Fraud

A jury has returned a guilty verdict against a former staff physician for the City of Houston of 14 counts of health care fraud in a $1 million health care fraud scheme, announced U.S. Attorney Kenneth Magidson. Jocelyn Pyles-Elo, M.D., 58, was convicted following a 3 ½ day trial in Houston.

The jury heard that Pyles worked full-time for the City of Houston and had entered into various agreements with the owner of Elite P. Medical Clinic that resulted in $1 million in health care claims being billed under her Medicare and Medicaid provider numbers.

The jury found Pyles guilty of 14 individual health care fraud counts that related to physician office visits and physical therapy services that she did not provide because she was actually working for the City of Houston at the time. In actuality, an unlicensed foreign medical graduate, who did not have a license, saw all the patients at the clinic alone. He was instructed not to sign patient progress notes at those visits. Pyles would come to the Houston location of the clinic after hours, when there were no patients present and then sign the treatment notes to make it appear she saw the patients when she did not.

The jury also heard that Pyles occasionally went to the Port Arthur location of the Elite clinic on Fridays during business hours, but still did not see patients. Again, the unlicensed foreign medical graduate saw the patients alone.

That individual testified at trial, identifying his handwriting and explaining what he did with the patients. The owner of the clinic, who had previously pleaded guilty for her role in the scheme testified that Pyles received $135,000 from her during the criminal activity.

Pyles is scheduled for sentencing on Feb. 1, 2016, at which time she faces up to 10 years in prison and a possible $250,000 fine on each count of conviction.

The conviction was the result of a joint investigation conducted by agents from the Department of Health and Humans Services – Office of Inspector General, FBI, and the Texas Attorney General’s Office - Medicaid Fraud Control Unit with assistance of Medicare Zone Program Integrity Contractor, Health Integrity LLC.

Outcome: Guilty

Plaintiff's Experts:

Defendant's Experts:

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