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Friday, February 26, 2016

Two Dallas-Area Doctors and Four Others Charged for Roles in $13.4 Million Medicare Fraud Scheme

Six individuals, including two Dallas-area doctors, were charged in a superseding indictment that was unsealed today for their alleged participation in a $13.4 million health care fraud scheme involving fraudulent claims for home health services.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney John Parker of the Northern District of Texas, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) Dallas Region, Special Agent in Charge Thomas M. Class Sr. of the FBI’s Dallas Field Office and Director of Law Enforcement David Maxwell of the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.  

Dr. Kelly Robinett, 66, of Denton County, Texas; Dr. Angel Claudio, 60, of Hood County, Texas; Patience Okoroji, 57, of Dallas County, Texas; Usani Ewah, 58, of Dallas County ; Kingsley Nwanguma, 45, of Dallas County; and Joy Ogwuegbu, 39, of Collin County, Texas, were each charged with one count of conspiracy to commit health care fraud.  The defendants were also each charged with health care fraud: Robinett and Nwanguma with three counts each, Claudio with two counts, Okoroji and Ewah with five counts each and Ogwuegbu with four counts.  Okoroji, Ewah, Nwanguma and Ogwuegbu were previously charged in the original indictment. 

Robinett, a doctor of osteopathic medicine, is the owner of Boomer Housecalls, based in Frisco, Texas.  Claudio, a medical doctor, is an employee of Dallas-based Texas Medical Housecalls.

Okoroji and Ewah co-owned Timely Home Health Services Inc. (Timely), where Okoroji was an administrator and licensed vocational nurse and Ewah was the director of nursing and a registered nurse.  Nwanguma was a licensed vocational nurse working for Timely and Ogwuegbu was the former director of nursing for Timely.

The indictment alleges that from approximately January 2007 to September 2015, the defendants conspired to defraud Medicare by causing the submission and concealment of false and fraudulent claims to Medicare.  According to the allegations, Robinett and Claudio falsely certified beneficiaries for home health care when the patients were not under their care and did not qualify for home health services.  The indictment also alleges that in some cases, Okoroji and Ewah would pay recruiters, including Nwanguma, to recruit beneficiaries for home health services, regardless of whether the beneficiaries needed home health care.  Okoroji, Ewah and Ogwuegbu allegedly prepared or caused to be prepared fraudulent Medicare documents that made it appear as though the beneficiaries qualified for home health services. 

The indictment alleges that during the scheme, the defendants billed Medicare approximately $13,434,550 based on false home health certification signed by doctors, including Robinett and Claudio, and false and fraudulent claims for home health services.

An indictment is merely an allegation and the defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law. 

HHS-OIG, FBI and the MFCU investigated the case, which was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Northern District of Texas.  Fraud Section Trial Attorney Jason Knutson is prosecuting the case.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,300 defendants who have collectively billed the Medicare program for more than $7 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

16-224
Topic: 
Healthcare Fraud
Updated February 26, 2016