Howard University Hospital Employee and Upper Marlboro Woman Charged in Separate Criminal Complaints with Defrauding Medicaid
Four Individuals Have Been Charged this Week
WASHINGTON – Folashade Adufe Horne, 51, of Laurel, Maryland, and Sikirat Adunni Brown, 58, of Upper Marlboro, Maryland, were both arrested today after being charged in federal court with defrauding the D.C. Medicaid program, announced Acting U.S. Attorney Michael R. Sherwin; James A. Dawson, Special Agent in Charge, FBI Washington Field Office, Criminal Division; Maureen R. Dixon, Special Agent in Charge of the U.S. Department of Health and Human Services’ Office of Inspector General for the region that includes Washington, D.C.; and Daniel W. Lucas, Inspector General for the District of Columbia.
Horne and Brown are the third and fourth individuals charged this week with defrauding D.C. Medicaid. Yesterday, Susan Engonwei Tingwei, a University of Maryland Law School Graduate, and Janet Akindipe, an employee at the National Institutes of Health (“NIH”), were arrested.
Horne, Brown, Tingwei, and Akindipe each were charged in separate criminal complaints with health care fraud and health care false statements for falsely claiming to have provided personal care aide (“PCA”) services to D.C. Medicaid beneficiaries. Horne is alleged to have defrauded Medicaid between January 2014 and the present. Brown is alleged to have defrauded Medicaid between November 2014 and the present. Tingwei is alleged to have defrauded Medicaid between January 2015 and September 2018. Akindipe is alleged to have defrauded Medicaid between January 2015 and the present.
Home health agencies employ PCAs to assist D.C. Medicaid beneficiaries with performing activities of daily living, such as getting in and out of bed, bathing, dressing, and eating. PCAs are required to accurately document the hours of care that they provide to beneficiaries on timesheets and then submit those timesheets to home health agencies, which in turn bill Medicaid for services actually rendered.
According to charging documents, Horne claimed to provide PCA services to beneficiaries when she was actually working at Howard University Hospital, where she has been employed since 2007. D.C. Medicaid claims data revealed that on 204 separate days in 2014, she purportedly provided 20 or more hours of PCA services to several Medicaid beneficiaries while working for various home health agencies, including 28 separate days where she claimed to work 32 hours. Charging documents also allege that Horne claimed to provide PCA services to D.C. Medicaid beneficiaries when she was traveling outside the United States.
Charging documents allege that Brown purported to provide PCA services in excess of twenty hours on a given day and also to multiple beneficiaries in overlapping hours. On 335 occasions between November 2014 and October 2015, Brown claimed that she provided between 20 and 38 hours of PCA services each day. She also asserted that she provided 176 hours of services during a seven-day period even though there are only 168 hours in a week. In addition, she is alleged to have paid kickbacks to at least one beneficiary to get that person to sign fraudulent timesheets.
Charging documents indicate that Tingwei earned a Master of Laws degree from the University of Maryland’s Francis King Carey School of Law in May 2017. On more than 100 occasions, she is alleged to have submitted timesheets purporting to have provided PCA services in Washington, D.C., when she was scheduled to be in Baltimore attending law school classes. As part of the investigation, law enforcement agents conducted surveillance of Tingwei and also obtained cell phone records that provided her location history. Tingwei claimed to provide PCA services in Washington at times when law enforcement agents saw her in Baltimore and also when cell phone records placed her in Baltimore.
Charging documents allege that Akindipe claimed to provide PCA services to beneficiaries when she was actually working at NIH. Between working at NIH and purportedly providing PCA services, Akindipe claimed she worked more than twenty hours a day on 338 different occasions between January 2015 and October 2018. She also is alleged to have caused Medicaid to be billed for PCA services that she purportedly rendered during three separate periods of time when she was actually traveling outside the United States.
Horne, Brown, and Akindipe appear this afternoon on their respective criminal complaints before the Honorable Robin M. Meriweather in U.S. District Court for the District of Columbia. Yesterday, Tingwei was presented before Judge Meriweather. A criminal complaint is a formal accusation of criminal conduct for purposes of establishing probable cause, but it is not evidence of guilt. Each of the defendants is presumed innocent unless proven guilty.
This week’s arrests mark a continued effort by the FBI, the Department of Health and Human Services’ Office of Inspector General, the District of Columbia’s Office of the Inspector General’s Medicaid Fraud Control Unit, and the U.S. Attorney’s Office to investigate and prosecute individuals who defraud the D.C. Medicaid program.
Since October 2019, four PCAs have been sentenced in U.S. District Court for defrauding D.C. Medicaid. Mobolaji Tina Stewart, who admitted defrauding the program out of more than $500,000, was sentenced to 13 months in prison in October 2019. Nkiru Uduji, who defrauded Medicaid out of more than $500,000, was sentenced to thirty-six months’ probation in December 2019. Rose Gana, who defrauded Medicaid out of more than $400,000 was sentenced to 13 months in prison in February 2020. Temitope Ogunbiyi, who defrauded Medicaid out of more than $1 million was sentenced to 15 months in prison in February 2020. A fifth defendant, Hope Falowo, pled guilty to defrauding Medicaid out of more than $400,000 in November 2019 and is awaiting sentencing. A sixth defendant, Charlotte Etongwe, was charged via criminal complaint in June 2019. A status hearing is scheduled in her case for July 29, 2020.
The FBI, the Department of Health and Human Services’ Office of Inspector General, and the Medicaid Fraud Control Unit have investigated all of these cases and count on the public for tips and assistance in helping stop health care fraud. If you have information about individuals committing health care fraud, please call the Department of Health and Human Services’ Office of Inspector General hotline at (800) HHS-TIPS [(800) 447-8477].
The cases against Horne, Brown, Tingwei, and Akindipe are being prosecuted by Assistant U.S. Attorney Kondi Kleinman.