| CBS correspondent Steve Kroft said that $60 billion annually was being siphoned off from Medicare, the federally funded health care program that provides basic medical insurance to qualified residents. It provides coverage for approximately 40 million American nationwide. The program was created in 1965 under the signature of President Lyndon Johnson, during which the Republican Party hauled accusations of socialized medicine, as they are now doing to the healthcare reform that President has proposed. Obama has said that closing the fraud in medicare would save a lot of time for his healthcare reform program.
It is not that $60 billion that aroused my interest, but a call a few days ago from someone I knew telling me that another Nigerian had been arrested for medicare fraud, and was looking for contributions to bail him out. This previously high flying individual had been thumping his nose at their organization, refusing to attend their meetings, and in fact encouraging others to do like wise. This was the second case for which I had been called, and it again centered on a Nigerian in the Houston, Texas, area.
While some might question the significance of $100 million which these few Nigerians have stolen compared to the $60 billion being stolen annually from the medicare program, it is the brazenness and the short periods of time that are most mind-boggling in the cases I found. In checking the data bases of those accused of medicare fraud, a Nigerian stands out as the one individual who ripped off the program with the highest amount of money in such a very short time. That dubious distinction belongs to one Mr. Umawa Oke Imo.
Umawa Oke Imo, 54, a permanent resident alien in the U.S. and native of the Federal Republic of Nigeria, was taken into federal custody on Friday June 26, 2009, following the filing of a criminal complaint which accused him of health care fraud. He has remained in court-ordered custody without bond since his arrest.
Imo is accused Imo of filing approximately $42 million worth of claims, predominantly for physical therapy services which were not performed at City Nursing, not performed by a licensed physical therapist and not performed by an appropriately supervised physical therapy assistant, with Medicare and Medicaid between Jan. 1, 2007, through April 30, 2009.
Approximately $30 million was paid by Medicare and Medicaid for these claims.
According to the indictment, Imo did not hire any licensed physical therapist to work at the clinic and did not have licensed physical therapy aides appropriately supervised. Imo allegedly paid Medicare and Medicaid beneficiaries approximately $100 to sign multiple blank forms indicating they received physical therapy when no such services were provided. Some beneficiaries reportedly received additional payments for not complaining to authorities. Imo also allegedly paid marketers for bringing beneficiaries to the clinic. The mail fraud charges center around three paper checks valued at approximately $180,448 that were mailed by the Medicaid contract administrator as payments to City Nursing in lieu of electronic fund deposits between March and May 2008.
Imo is also charged with money laundering and is accused of engaging in five transactions occurring between April 2008 and March 2009, each more than $10,000 and totaling $2,805,195 from a City Nursing bank account for referrals, the purchase and shipping of tankers to Lagos, Nigeria, and a check for more than $1 million payable to Imo himself.
That total of approximately $4 million between the shipping of the tankers and the one payment of $1 million is approximately N600 million in the Naira denominated currency of Nigeria. We are talking of N600 million of known transactions out of the $30 million that medicare and medicaid had paid him. You wonder why some of us are always asked whether we really reached America, i.e. do we know what others are doing and getting rich so quickly!
In an October 26, 2009, press release from the United States Attorney’s Office for the Southern District of Texas, comes the following: A 51-count superseding indictment charging three additional defendants for allegedly conspiring with Umawa Oke Imo to commit health care fraud and other offenses arising from a $45 million health care fraud scheme has been unsealed, United States Attorney Tim Johnson and Texas Attorney General Greg Abbott announced today.
Imo, 54, born in the Federal Republic of Nigeria and owner of City Nursing Services of Texas Inc., has been in federal custody without bond since June 26, 2009, awaiting trial on 36 counts of conspiracy, health care fraud, mail fraud and money laundering. Today, a superseding indictment which incorporates the original 36 counts and adds 15 new counts and names three new defendants was unsealed. Two of the newly named defendants, Kenneth Anokam, 54, a naturalized citizen, and Joann White, 45, both Houston residents, were arrested by agents from the FBI, Internal Revenue Service–Criminal Investigation Division (IRS-CID), Texas Attorney General’s Office Medicaid Fraud Control Unit (MFCU) and the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) on Thursday, Oct. 22, 2009. The third defendant, Dr. Thaddeus Hume, 62, a Houston-area physician, surrendered himself to federal authorities this morning. All three newly named defendants appeared before United States Magistrate Judge Stephen Wm. Smith this afternoon. The United States has moved for the detention of Anokam and White; Hume will be released on bond.
The superseding indictment returned under seal on Oct. 19, 2009, charges all four defendants with 39 counts of health care fraud and conspiracy to commit health care fraud. Imo, Anokam and White are also charged with three counts of mail fraud and Imo is charged with five counts of money laundering.
According to the superseding indictment, approximately $45 million dollars worth of claims were billed to Medicare and Medicaid by City Nursing over approximately two and a half years, almost all for physical therapy services not provided to patients at City Nursing, not provided by a licensed or qualified physical therapist and not provided by appropriately-supervised physical therapy assistants and physical therapy aides. Approximately $30 million dollars was paid by Medicare and Medicaid for these claims.
On Tuesday, September 8, 2009, Kalu Kalu, a Nigerian living in Raleigh, North Carolina, who federal investigators say was at the center of an operation that pocketed more than $12 million from false Medicare claims pleaded guilty to fraud.
Kalu Kalu pleaded guilty to one count each of conspiracy to commit health care fraud and health care fraud. He will be sentenced Dec. 14, when he faces up to 15 years in prison.
Kalu, his wife, Kecia Kalu, and two others indicted in the case would recruit and train salespeople to establish relationships with Medicare patients to obtain their Medicare numbers and personal information, according to federal investigators.
Investigators allege that the couple used the Medicare provider number of co-defendant Martin Ifeani Iroegbu to submit bogus claims for scooters. The Kalus also are alleged to have used their Raleigh businesses, Enuda Healthsource and Universal Medical Supplies, to bill Medicare for health care aids that were never provided to beneficiaries.
As part of a plea agreement, 15 counts of health care fraud will be dismissed against Kalu Kalu when he is sentenced, defense attorney Paul Sun said.
“Consistent with this plea agreement Mr. Kalu is cooperating fully (with authorities),” Sun said.
Iroegbu has already pleaded guilty to health care fraud and aiding and abetting. He is expected to begin serving a 26-month prison sentence in November.
Kecia Kalu is scheduled for arraignment on Sept. 28.
The fourth defendant in the case is Nnenna K. Cornett, who operates States Medical Products LLC in Raleigh. She faces 16 counts of health care fraud and one count of conspiracy to commit fraud, but it’s unclear whether she has been arrested.
The U.S. Department of Health and Human Services Office of the Inspector General reported in May that more than 10 percent of the $920 million Medicare paid in 2005 for powered wheelchairs had been misspent.
On Monday, July 6, 2009, Emmanuel Uko Akpan of McKinney received a 60 month sentence in federal court and an order to pay more than $710,000 on Tuesday in the U.S. District Court of Northern Texas, according to officials with the Internal Revenue Service’s Criminal Investigation Division of Dallas.
Akpan owned and operated Atbestcare Medical Equipment and Supply Company of Dallas and conspired with Geneva Sanders, an employee of the emergency room at Methodist South Hospital of Memphis, Tenn. and Walter Sanders, owner of Waltco Medical Equipment and Supplies located in Mesquite, according to the indictment.
The object of the scheme was to “sell and use the means of identification of Medicare beneficiaries and physicians located in Tennessee and elsewhere to [several companies]…for the purpose of executing a scheme to defraud Medicare and to obtained money from Medicare through false representations,” according to the indictment.
Sanders obtained the names and personal identification numbers of patents from hospital records and sent them to Sanders “without the authorization of such Medicare beneficiaries, in exchange for remuneration.” Sanders and Akpan also visited or directed others to visit beneficiaries to obtain their personal information.
Officials estimate that Sanders and Akpan obtained more than 70 patient records as part of their scheme. They would immediately bill Medicare for false claims for power wheelchairs. After they submitted the claims, some of the beneficiaries would receive less expensive scooters or no equipment at all.
Prosecutors believe the scheme consisted of false claims ranging between $5,800 and $9,800 from February to August of 2003. The claims totaled more $2.7 million netting payments from Medicare totaling $1.3 million, according to the indictment.
On Friday, December 7, 2007, Christian Onwuegbusi, 56, owner of Houston-based Texas Memorial Medical Institute Rehabilitation Services, was convicted of theft by a government contractor for fraudulently billing Medicare for motorized wheelchairs that were never delivered.
Testimony in state District Judge Devon Anderson’s court also showed that Onwuegbusi overbilled Medicaid for physical therapy services, some that were never provided.
Harris County prosecutors argued that the defendant billed the government more than $900,000 for motorized wheelchairs and then delivered less-expensive scooters.
The case was investigated by the Medicaid Fraud Control Unit of the Texas Attorney General’s Office; the FBI; and the Office of Inspector General of the Health and Human Services Commission.
A Sugar Land couple who admitted to bilking Medicare and Medicaid in a health care fraud conspiracy was sentenced in a Tyler federal court Wednesday to more than two years in prison and ordered to pay nearly $300,000 to the victims.
Gloria Okwunwanne, 47, and Arthur Rapor, also known as Peter Ukono, 49, pleaded guilty to conspiracy to commit health care fraud and money laundering.U.S. District Judge Leonard Davis sentenced both defendants to 27 months in prison and ordered them to pay $284,689 in restitution.
Ms. Okwunwanne, who was out of jail on bond, paid the restitution in full Wednesday and was ordered to voluntarily surrender to a federal prison on Nov. 30 while Rapor remained in federal custody. They will each have to serve three years of supervised release after their prison terms.
They were charged with conspiring to commit health care fraud in Gregg County from October 2001 through December 2003. Through All Medical Supply and other suppliers in Gregg County, the defendants submitted fraudulent claims to the two benefit programs for the cost of motorized wheelchairs and accessories.
The seven-count indictment states that the amount of fraud totaled about $427,150.The couple paid people to obtain Medicaid and Medicare beneficiary information and took it back to their business in Houston to receive benefits, Assistant U.S. Attorney Katherine Miller said earlier in court.
The defendants also had one check drawn for $17,020, which was proceeds from the health care fraud, she said.Ms. Okwunwanne and Rapor faced up to five years in prison for the fraud charge and up to 10 years in prison on the money laundering charge.On March 8, Artis Anderson was sentenced to two years in prison for defrauding Medicare of more than $800,000 by filing false claims for motorized wheelchairs and scooters only issued when medically necessary.
From April 2002 through 2003, Anderson, a 66-year-old Longv-iew resident, conspired and executed a scheme to obtain money and property owned by Medicare, with the delivery of and payment for health care benefits, even though the beneficiaries didn’t qualify.Assistant U.S. Attorney Traci Kenner said at the time that Anderson cooperated with the government in Rapor and Ms. Okwunwanne’s case. He also provided exceptional cooperation to the government by testifying against a Houston doctor who was “heavily involved in wheelchair fraud.”
Again in Houston, four people who were licensed to operate facilities that treat chemical dependency were arrested on allegations of charging the state Medicaid program $160,000 for services never rendered.
The facilities, all in southwest Houston, were contracted with Texas Health and Human Services to offer chemical dependency treatments for Medicaid patients. The companies, in turn, were reimbursed by the state for those services.
All four providers have been charged with felony theft by a government contractor for their involvement in alleged false billing for treatments and counseling sessions not performed, said Tom Kelley, a spokesman for Texas Attorney General Greg Abbott.
Those arrested are William Onyewuchi Nwanguma, 51, a Sugar Land man who owns Willuc Services Inc., 6610 Harwin; Uzoma Mark Ohuonu, 50, and his wife, Lorie Penaflor Ohuonu, 56, who operated Unique Medical and Rehab Center at 6400 Westpark; and Bernard Askika Chieke Ejiogu, 44, owner of BACE THT Alcohol and Drug Center, 11039 Bissonnet.
Kelley said the investigation by Abbott’s Medicaid Fraud Control Unit was initiated after state audits discovered “discrepancies” between billing and services in 2004 and 2005, which led to the revoking of licenses of the Ohuonus, Ejiogu and Nwanguma to treat and counsel Medicaid patients at their chemical dependency centers.
On Wednesday, March 7, 2009, Chidi Ikeh, owner of two physical therapy clinics, including one in Cherry Hill, admitted defrauding Medicare of about $3.8 million, U.S. Attorney Christopher J. Christie (now New Jersey’s governor-elect) announced.
Chidi Ikeh, 44, of Houston, Texas, entered his guilty plea this week just before his trial was to begin in U.S. District Court in Trenton before Judge Garrett E. Brown Jr.
Ikeh owned and operated Vital Health Care Services in Ewing and U.S. Vital Health Care Services, Inc. in Cherry Hill.
From February 2002 until August 2005, he admitted billing Medicare for approximately $3.79 million for fraudulent physical therapy services, evaluations, and re-evaluations allegedly provided to patients, according to a news release from Christie’s office.
Ikeh admitted services were either never performed, were not supervised by a licensed physician or were performed by unqualified individuals.
Ikeh admitted that he had van drivers, receptionists and others who had no licensing or certification in physical therapy, as required by law, perform physical therapy on Medicare patients, the news release said.
Ikeh also admitted to instructing staff to indicate in the medical records that they performed certain physical therapy procedures on patients when, in fact, no such procedure was performed.
Ikeh was arrested on Sept. 15, 2006 by federal agents when he returned from his native country of Nigeria to his hometown of Houston.
On February 24, 2007, agents from the Florida Department of Law Enforcement arrested Titilayo Idowu Dokun, 43, who headed Capital City Area Care.
From October 2004 through November 2006, Kiracofe said, Dokun filed for assistance to the Department of Children and Families claiming financial need. During periodic certification interviews, she neglected to report her income as CEO of $339,409 during the time she was receiving public assistance, said Phil Kiracofe, FDLE spokesman.
Investigators say Dokun received $11,518 in Medicaid services and food stamps. Dokun was arrested in December on charges of grand theft with accusations that she defrauded the Florida Medicaid program out of more than $100,000, Kiracofe said.
Dokun had an address in the 3000 block of Evanwood Court. The business is not listed in the phone book, nor is it listed with the state division of corporations.
Since the Attorney General’s office determined she was collecting fraudulent assistance they contacted us,” Kiracofe said. The Attorney General’s office was investigating Dokun for Medicaid fraud. “Her privileges for managing any kind of public assistance funds have been suspended,” Kiracofe said.
On February 13, 2007, this young Nigerian, Kennedy Igbokwe, 29, a citizen of Nigeria, was sentenced by U.S. District Judge Gary A. Fenner this morning to five years and three months in federal prison without parole. The court also ordered Igbokwe to pay $750,000 in restitution and to forfeit to the government $500,000 and all the funds in a bank account. Schlozman noted that today’s sentence is the harshest penalty provided under the federal sentencing guidelines.
“After being welcomed as a guest in this country, the defendant plundered the Medicare program in an outrageously bold and rapacious health care fraud scheme,” Schlozman said. “Every dollar he stole from the Medicare program is a dollar deprived from elderly Americans who depend on Medicare for their health care needs.”
On Aug. 30, 2006, Igbokwe was convicted by a federal jury of health care fraud as well as multiple counts of illegally structuring currency transactions and money laundering. Between January 2002 and September 2005, Igbokwe and co-defendants submitted more than $5 million worth of false and fraudulent claims to Medicare on behalf of nearly 1,000 Medicare recipients, resulting in their actual receipt of more than $2 million from Medicare.
Igbokwe, who owns and operates Cardinal Healthcare at 1105 E. 47th St., in Kansas City, bribed two physicians, who were charged as co-defendants in the federal indictment, to falsely verify that Medicare beneficiaries were so physically disabled that they needed motorized wheelchairs. Igbokwe then billed Medicare for 423 power wheelchairs totaling more than $2.5 million ( Medicare actually paid Igbokwe approximately $1.5 million).
The physicians have admitted that at least half of those claims were fraudulent. After receiving approximately $4,000 from Medicare for each of these false and fraudulent claims, Igbokwe provided some Medicare beneficiaries with a less expensive scooter instead. In some instances, Igbokwe did not provide the Medicare beneficiary with any type of power wheelchair or scooter.
Igbokwe was also found guilty of 19 counts of structuring currency transactions so as to evade the federal reporting requirements. Igbokwe made a series of cash withdrawals of $10,000 or less between March 21 and Nov. 18, 2005, in order to evade the federal requirement for filing a Currency Transaction Report.
Igbokwe was also found guilty of four counts of money laundering. Igbokwe caused a series of wire transfers of funds derived from the health care fraud to be sent from an account he controlled at U.S. Bank to another bank account. On Oct. 14, 2005, $33,400 was wired from the Cardinal Healthcare account. On Nov. 14, 2005, $47,500 was wired from the Cardinal Healthcare account. On Nov. 15, 2005, $56,000 was wired from the Cardinal Healthcare account. On Dec. 1, 2005, $73,400 was wired from the Cardinal Healthcare account.
Four additional co-defendants, including the owners of two medical supply companies and two former physicians, have pleaded guilty to their roles in the health care fraud scheme. Co-defendant Godwin Iloka, 39, a naturalized U.S. citizen from Nigeria residing in Lee’s Summit, Mo., was sentenced on Nov. 20, 2006, to three years in federal prison without parole.
The court also ordered Iloka to forfeit to the government his residence in Lee’s Summit, a 2003 Ford Explorer, a 2004 Honda Accord, a 2004 Chevrolet van, and all funds in two bank accounts, all of which represent the proceeds of his criminal activities. Iloka owns and operates Xcellent Medical Service at 9500 E. 63rd St. in Raytown, Mo., and Xcellent Medical Services at 4403 Blue Parkway in Kansas City.
Iloka’s sentence includes a two-year term of incarceration for the Medicare fraud and a consecutive one-year term of incarceration on a revocation of Iloka’s supervised release in an unrelated federal case. On Aug. 9, 2004, Iloka pleaded guilty to credit card fraud and was sentenced to five years of probation and ordered to pay $34,882 in restitution. Iloka’s criminal activities violated the terms of his supervised release, which was therefore revoked.
On July 12, 2006, Iloka pleaded guilty to his role in a scheme to defraud Medicare between Jan. 24, 2002, and Sept. 15, 2005. Iloka submitted claims to Medicare for power wheelchairs, then after Medicare paid those claims, he provided beneficiaries with a less expensive motorized scooter instead of the power wheelchair. Medicare sustained a loss of $84,000 as a result.
Iloka also admitted that he engaged in three additional fraud schemes that resulted in a total loss of $331,162.
Iloka engaged in a similar scheme to defraud Medicare during the same time frame, from Jan. 24, 2002, to Sept. 15, 2005. Iloka submitted claims to Medicare for custom-molded diabetic shoes, then after Medicare paid those claims, he provided Medicare beneficiaries with much less expensive standard diabetic shoes instead of the more expensive custom-molded diabetic shoes he had billed to Medicare. Medicare sustained a loss of $165,000 as a result of this fraud scheme.
Iloka engaged in a scheme to commit Social Security disability fraud in which he fraudulently applied for and received Social Security disability benefits while engaged in the medical equipment supply business. The United States sustained a loss of $67,162 as a result of this fraud scheme.
Iloka engaged in a credit card fraud scheme in which he used the personal information of another person, without authorization, to obtain an American Express credit card and line of credit, after which he fraudulently accessed the line of credit to obtain $15,000.
Kenneth Agugua, 48, with addresses in both Kansas City, Mo., and Houston, Texas, a permanent resident alien from Nigeria, was sentenced on Jan. 4, 2007, to two years and nine moths in federal prison without parole. The court also ordered Agugua to pay $361,811 in restitution.
On Aug. 23, 2006, Agugua pleaded guilty to health care fraud. Agugua owns and operates Primecare Management, Inc., a durable medical equipment company at 1734 E. 63rd St., in Kansas City. Agugua admitted that he engaged in an “upcoding scheme” to defraud Medicare in which he submitted claims to Medicare for power wheelchairs.
After Medicare paid those claims, however, he provided Medicare beneficiaries with a less expensive motorized scooter instead of the power wheelchair he had billed to Medicare. Agugua also admitted that the Medicare program sustained a loss of $561,000 as a result of his scheme.
Two former physicians pleaded guilty to their role in the Medicare wheelchair fraud. Co-defendant Amazair McAllister, 49, of Blue Springs, was sentenced on Nov. 21, 2006, to one year and one day in federal prison without parole. The court also ordered McAllister to pay $1 million in restitution and to forfeit $100,000 to the government, which represents the proceeds of his criminal activities. McAllister pleaded guilty on July 10, 2006, to health care fraud and agreed to surrender his medical licenses and cease practicing medicine.
Co-defendant Ambrose Wotorson, 71, a naturalized U.S. citizen from Liberia residing in Kansas City, pleaded guilty on Feb. 24, 2006 to health care fraud. Wotorson was a licensed osteopathic physician and surgeon during the time of the fraud scheme, but has surrendered his medical license and no longer practices medicine. Wotorson is scheduled to be sentenced on March 5, 2007.
As we have seen, most of these cases involved Nigerians, except for the one case of the Liberian Wotorson. There was another case of the Ghanaian, Charles Jyamfi, 53, of West Orange, Pedro Diaz, 77, of Elizabeth, and Aiad Saman, 52, of Staten Island, N.Y., were each charged with first-degree conspiracy to commit racketeering, first-degree racketeering, second-degree conspiracy to commit fencing, second-degree fencing and second-degree receiving stolen property. In addition, Jyamfi was charged with first-degree money laundering, and Saman with third-degree perjury. The indictment was returned by the state grand jury on July 27 but was sealed by the court until yesterday afternoon.
The indictment alleges that Jyamfi, a licensed New Jersey pharmacist, ran his now defunct pharmacy, Ojah Pharmacy in East Orange, as a racketeer influenced and corrupt organization, with assistance from Saman, Diaz and others. Saman was also a licensed pharmacist. Between August 2002 and October 2004, Jyamfi allegedly purchased approximately $2 million in stolen prescription drugs from Saman, Diaz, and others. Jyamfi allegedly used the stolen drugs to stock his pharmacy. He allegedly sold the stolen medications, which were sometimes improperly packaged and labeled, to the general public, including persons covered by Medicaid.
It is possible that our findings so far is a tip of the iceberg. The question is why do Nigerians seem to participate and dominate in these fraudulent schemes. Yet, we turn around to accuse our leaders back home of corruption? Of course, it could be argued that here, if you are caught, you are tried and incarcerated if found guilty, while back home people get away with murder, in this case stealing a lot of the country’s funds.
The question regarding the latest case that drew my attention to this investigation is why should somebody who is making millions be asking us for contributions to bail him out. Look at one of the cases where the woman paid the restitution in full, without even batting an eye.
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Eye witnesses said the killers had asked the deceased ‘where is the
money?
