Late yesterday, a federal jury in the Northern District of Texas convicted a physician and a home health agency manager for their participation in a $3 million Medicare fraud conspiracy.
Acting Assistant Attorney General David A. O’Neil of the Justice Department’s Criminal Division, U.S. Attorney Sarah R. Saldaña of the Northern District of Texas, Special Agent in Charge Diego Rodriguez of the FBI Dallas Division and Special Agent in Charge Mike Fields of the Dallas office of the Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations made the announcement.
Joseph Megwa, M.D., and Ebolose Eghobor, R.N., were convicted of one count of conspiracy to commit health care fraud, and Megwa was convicted of three substantive counts of health care fraud. Eghobor was acquitted of the three substantive health care fraud counts brought against him. The home health care charges related to a scheme involving PTM Healthcare Services Inc. (PTM), which was owned and operated by Ferguson Ikhile, R.N. Ikhile pleaded guilty in 2013 to conspiracy to commit health care fraud.
According to evidence presented at trial, from approximately 2006 to 2011, PTM recruited Medicare beneficiaries so that PTM could bill Medicare for unnecessary home health services. Ikhile, Eghobor and others then prepared fraudulent medical records that made it appear that the beneficiaries needed home health services. In exchange for cash payments, Megwa, who owned and operated Raphem Medical Practice P.A., falsely certified that the beneficiaries needed home health services and that the services otherwise qualified for payment under Medicare.
Megwa was also convicted of four counts of making false statements related to a health care benefit program based on his submission of false claims to Medicare for home visits or house calls to patients that he never actually made.
The investigation was led by the FBI, HHS-OIG and the Medicaid Fraud Control Unit of the Office of the Texas State Attorney General and was brought by the Medicare Fraud Strike Force, a joint effort of the U.S. Attorney’s Office for the Northern District of Texas and the Criminal Division’s Fraud Section. The case was prosecuted by Deputy Chief Jeffrey A. Goldberg and Trial Attorney Allan J. Medina of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.