Home Health & Hospice Week

Operation Wheeler Dealer scores first hits in Lone Star state.  Aggressive enforcement of fraud in the power wheelchair arena - which has been simmering for months - is now reaching a boil. Two weeks after the feds announced a sweeping crackdown on fraudulent power wheelchair claims, the U.S. Department of Justice brought charges against seven Houston-area suppliers, physicians and recruiters for allegedly participating in an elaborate kickback scheme. According to U.S. Attorney Michael Shelby, the indictments involved two plots that cost Medicare and Medicaid more than $30 million. Both alleged schemes have the same basic template: Durable medical equipment suppliers purportedly paid recruiters to solicit Medicare and Medicaid beneficiaries to acquire a power wheelchair; the recruiters transported the beneficiaries to a doctor's office, and the doctor, in exchange for a kickback from the suppliers, signed off on a bogus certificate of medical necessity; the suppliers then purportedly delivered the beneficiary a less expensive wheelchair or scooter than what they billed for - or didn't supply the item at all. FBI Special Agent Richard Garcia said at a press conference that the recruiters, who were paid between $200 and $800 for each person they qualified for a power wheelchair, would often go to trailer parks and look for anyone willing to accept $200 in exchange for participating, the Associated Press reports. In the first alleged scheme, a grand jury returned a 101-count indictment, which was unsealed Sept. 19, leveling health care fraud, conspiracy and kickback charges against Dr. Anant Mauskar; his office manager Nadine Norman; Aniefok Eking, owner of DME companies Medical Equipment and Supplies and Mescorp; Eking's employees - and alleged patient recruiters - Lorine Hawthorne and Pamela Russell; and Ita Obot, owner of Best Medical Equipment and Supplies. In the second case, Dr. Lewis Gottlieb was slapped with similar charges in a nine-count criminal filing. For $200 a pop, he allegedly secured CMNs for four DME suppliers - 1st Choice Medical Equipment and Supply, Thurman Family Medical Supply, Senior's Comfort Care Medical Supply, all located in Houston, and Access Medical Supply located in Stafford, TX. All four suppliers began operating during 2001 and 2002 and ceased to conduct business during April and June 2003, after Medicare either revoked their supplier numbers or suspended payments, Shelby says.

Senator Turns Up Heat The filings come on the heels of a major crackdown on illegitimate power wheelchair claims announced Sept. 9 by the Centers for Medicare & Medicaid Services (see pdf of Eli's HCW, Vol. XII, No. 32, p. 251). And don't expect the feds to let up on wheelchair scrutiny after they've caught the first round of obvious culprits. Influential Senate Finance Committee Chair Charles Grassley (R-IA) has asked the HHS Office [...]