Owner of Medical Clinic and Accountant Plead Guilty for Roles in $50 Million Medicare Fraud Scheme
WASHINGTON – The owner and operator of a New Orleans-based medical clinic and an accountant pleaded guilty today in federal court in New Orleans for their roles in a $50 million Medicare fraud scheme.
Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Kenneth A. Polite Jr. of the Eastern District of Louisiana, Special Agent in Charge Michael J. Anderson of the FBI’s New Orleans Field Office, Special Agent in Charge Mike Fields of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Dallas Regional Office and Louisiana Attorney General James D. “Buddy” Caldwell made the announcement.
Paige Okpalobi, 58, of Slidell, Louisiana, and Christopher White, 48, of Destrehan, Louisiana, pleaded guilty before Chief U.S. District Judge Sarah S. Vance of the Eastern District of Louisiana to one count of conspiracy to commit health care fraud and one count of conspiracy to falsify records in a federal investigation. Sentencing hearings for each are scheduled for July 1, 2015.
According to her plea agreement, Okpalobi owned and operated a New Orleans-based medical clinic that employed doctors to certify that Medicare beneficiaries were qualified to receive home health care. Okpalobi admitted that doctors employed at her clinic falsely certified that certain of their clients—specifically, Medicare beneficiaries—were homebound and in need of home health care services. Okpalobi further admitted that she and other co-conspirators then used the false certifications to bill Medicare for fraudulent home health care services through home health care companies she jointly operated with another co-conspirator.
According to his plea agreement, White managed financial and accounting services at Okpalobi’s companies and other companies. White admitted that he coordinated the payment of patient recruiters who illegally sold Medicare beneficiary information to Okpalobi and her co-conspirators. This information was used by home health companies operated by Okpalobi and others to bill Medicare for home health care services that were not medically necessary and often not delivered at all.
Okpalobi and White each also admitted that they fabricated tax and employment records in response to a federal grand jury subpoena to conceal the illegal kickbacks paid and mislead the grand jury.
Okpalobi admitted that between 2007 and 2014, she caused the submission of $49,989,323 in claims to Medicare for home health services that were not medically necessary or not provided.
Thirteen individuals have been indicted in connection with this Medicare fraud scheme, and eight have now pleaded guilty, including two doctors employed at Okpalobi’s medical clinic.
This case was investigated by the FBI, HHS-OIG and the Louisiana Attorney General’s Medicaid Fraud Control Unit (MFCU), and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Louisiana. This case is being prosecuted by Trial Attorneys William Kanellis and Antonio Pozos and Assistant Chief Benton Curtis of the Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5 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.
To learn more about the Health Care Fraud Prevention and Enforcement Team (HEAT), go to: www.justice.gov/criminal-fraud/health-care-fraud-unit.