HOME HEALTH BUSINESS OWNERS, NURSES CHARGED FOR PARTICIPATION IN FRAUD OF OVER $13 MILLION

FROM:  U.S. JUSTICE DEPARTMENT   

Tuesday, December 22, 2015

Dallas-Based Home Health Company Owners and Nurses Charged for Roles in $13.4 Million Medicare Fraud Scheme

The co-owners of a home health company in Dallas and two nurse employees were charged in an indictment unsealed yesterday 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 CJ Porter of the Health and Human Services-Office of Inspector General’s (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.

Patience Okoroji, 57, Usani Ewah, 58, Kingsley Nwanguma, 45, all of Dallas County, Texas, and Joy Ogwuegbu, 39, of Collin County, Texas, were each charged with one count of conspiracy to commit health care fraud.  In addition, Okoroji and Ewah are each charged with five counts of health care fraud; Nwanguma is charged with three counts of health care fraud and Ogwuegbu is charged with four counts of health care fraud.

Ewah,  Nwanguma and Ogwuegbu were arrested yesterday and made their initial appearances before U.S. Magistrate Judge Renee H. Toliver of the Northern District of Texas.  Okoroji was also arrested yesterday and will have her initial appearance today.

Okoroji and Ewah co-owned Timely Home Health Services Inc. (Timely), where Okoroji was also 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 a registered nurse working 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, Okoroji and Ewah would in some cases 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 that the beneficiaries qualified for home health services.  These documents were used by doctors to certify Medicare beneficiaries for home health care.

The indictment alleges that during the scheme, Okoroji and Ewah billed Medicare approximately $13,434,550 based on 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 Texas Attorney General’s 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.  Trial Attorney Jason Knutson of the Criminal Division’s Fraud Section 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.

HOME HEALTH CARE NURSE PLEADS GUILTY TO MEDICARE FRAUD

Wednesday, August 31, 2011
“WASHINGTON – Miami-area resident Farah Maria Perez, a registered nurse, pleaded guilty today for her participation in a $25 million Medicare fraud scheme involving false billings for home health services, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).
Perez, 40, pleaded guilty before U.S. District Judge Joan A. Lenard in Miami to one count of conspiracy to commit health care fraud. She was originally charged in a February 2011 indictment.
According to plea documents, Perez worked for Florida Home Health Care Providers Inc., a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries. Perez and her co-conspirators operated Florida Home Health for the purpose of billing the Medicare program for expensive physical therapy and home health care services that were medically unnecessary and/or never provided. The medically unnecessary services were prescribed by doctors.
According to court documents, beginning in approximately January 2006 and continuing until approximately March 2009, Perez and her co-defendant nurses falsified patient files for Medicare beneficiaries to make it appear that they qualified for home health care and therapy services from Florida Home Health. Perez admitted that she knew the beneficiaries did not actually qualify for and did not receive the services. Perez and her co-defendant nurses described in nursing notes and patient files symptoms such as tremors, impaired vision, weak grip and inability to walk without assistance. Although the patients did not actually exhibit these symptoms, the symptoms were nevertheless included in patient files to make it appear that the patients were unable to self-inject insulin and were homebound, thus appearing to qualify for home health care benefits under Medicare. Perez admitted that she knew the files were falsified so that the Medicare program could be billed for medically unnecessary therapy and home health related services. As a result of Perez’s participation in the illegal scheme, the Medicare program was billed approximately $118,000 for purported home health care services that were medically unnecessary and/or never provided.
Perez also admitted that she recruited Medicare beneficiaries who would allow Florida Home Health to bill the Medicare program for home health care and therapy services that were unnecessary or never provided. Perez solicited and received kickbacks and bribes from the owners and operators of Florida Home Health in return for allowing Florida Home Health to bill Medicare on behalf of the patients she recruited. Perez knew that the patients did not qualify for the services that were billed to Medicare.
Four other co-conspirators who were charged in the February 2011 indictment for their roles in the Florida Home Health fraud scheme have pleaded guilty: Jose Nunez, M.D.; Lisandra Alonso; Luisa Morciego; and Vicente Guerra.
Sentencing for Perez is scheduled for Nov. 14, 2011.
The charge of conspiracy to commit health care fraud carries a maximum prison sentence of 10 years. The defendant also face fines and terms of supervised release, as well as forfeiture of any property or proceeds derived from her criminal activities.
Today’s charges were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent-in-Charge of the FBI’s Miami field office; and Special Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office.
The case was investigated by the FBI and HHS-OIG, and 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 for the Southern District of Miami.”