DEPARTMENT OF JUSTICE
United States Attorney Gretchen C. F. Shappert
Western District of North Carolina
FOR IMMEDIATE RELEASE
Friday, November 21, 2008
CONTACT: Suellen Pierce
704.338.3120
Fax: 704.227.0264
CHARLOTTE PHYSICIAN TO PAY $1.7 MILLION TO SETTLE GOVERNMENT CIVIL FRAUD ALLEGATIONS Benedict O. Okwara, M.D. has entered into a settlement agreement under which he will repay $1.7 million to government health care programs in order to resolve government allegations that he billed the Medicare and Medicaid programs for services he never provided. The announcement was made jointly by Gretchen C.F. Shappert, United States Attorney for the Western District of North Carolina, and by North Carolina Attorney General Roy A. Cooper.
The settlement was reached following a multi-year investigation by state and federal agents into the Charlotte internist’s billing practices. The government’s investigation arose out of a referral by the Program Integrity Section of the North Carolina Division of Medical Assistance. Investigators also found that Dr. Okwara knowingly billed the Medicare, Medicaid and Federal Employee Health Benefit (FEHBP) Programs for more extensive services than he actually provided, a practice known as “upcoding.” By upcoding, Dr. Okwara was reimbursed for significantly more than he would otherwise have received for his work. Government investigators found that Dr. Okwara also regularly billed Medicare, Medicaid and FEHBP for unnecessary services and sometimes billed twice for the same services performed in his offices.
Government investigators uncovered evidence that Dr. Okwara committed billing fraud despite his having received repeated warnings that his billing practices were illegal. The billings at issue were submitted over a seven- year period from 1999-2006 inclusive.
As a condition of the civil settlement, Dr. Okwara was required to reimburse the government for the amount he wrongfully received from the programs and also pay substantial penalties back to the programs. The $1.7 million settlement figure represents more than twice the wrongful billings Dr. Okwara submitted to the government. Dr. Okwara was additionally required to enter into an integrity agreement with the U.S. Department of Health and Human Services. Under this agreement, Dr. Okwara has been required to hire at his own expense a government approved auditor who will monitor his billing practices for a five- year period to ensure that neither he nor his clinics commit similar offenses against government health programs in the future.
The funds recovered will be returned to the three government programs that were the victims of Dr. Okwara’s wrongful billing practices. The Medicare Program pays for health care services provided to persons over 65 and for disabled individuals. The Medicaid Program provides payment for the health care costs of indigent North Carolinians. The FEHBP Program pays for the health care costs of federal employees.
The investigation was conducted jointly by the North Carolina Medicaid Investigations Unit, the Office of the United States Attorney for the Western District of North Carolina, the United States Department of Health and Human Services Office of Inspector General, the United States Office of Personnel Management, and the United States Postal Inspection Service.
The settlement resolved Government allegations that Dr. Okwara’s behavior violated the federal False Claims Act. Under the False Claims Act, physicians and other health care providers who submit false claims for reimbursement to the government are liable for up to three times the damages caused in addition to penalties of up to $11,000 per violation. Dr. Okwara owns First Care Medical Clinic, which has offices in Charlotte, Monroe, Indian Trail, Locust, and Albemarle.
Charles H. Hobgood, Director of the North Carolina Medicaid Fraud Investigations Unit, handled the case for the North Carolina Attorney General’s Office. Assistant United States Attorney Donald H. Caldwell, Jr. handled the case for the Office of the United States Attorney in Charlotte.