Home Health & Hospice Week

Plus: Shocking 75-year sentence being appealed in Houston fraud case.

It may not be the 75-year prison sentence Fiango Home Healthcare Inc. owner Marie Neba received back in August, but nearly 17 years incarcerated is nothing to sneeze at.

Physician Noble U. Ezukanma received a 200-month sentence and was ordered to pay $34 million in restitution following his conviction in a home health Medicare fraud case in March. Ezukanma, co-owner of US Physician Home Visits, falsely certified patients for home care. “More than 97 percent of USPHV Medicare patients received home health care, whether they needed it or not,” the Department of Justice says in a release. Ezukanma and another USPHV doc certified 94 percent of the Medicare beneficiaries receiving home health services from A Good Homehealth, and 65 percent from Essence Home Health.

On the physician practice side, “USPHV submitted billing primarily under Dr. Ezukanma’s Medicare provider number, regardless of who actually performed the service,” the release says. “They billed at an alarming rate, generally billing for only the most comprehensive physician exam, and always adding a prolonged service code.”

“This is the kind of flagrant fraud that drives up health care costs to consumers everywhere,” Texas U.S. Attorney John Parker says in a release. “In return, this office will do everything we can to drive up the costs to those who choose to engage in health care fraud as a profession.”

Meanwhile: That unprecedented 75-year sentence for Neba may not stand.

Legal observers had a hard time understanding the sentence in the first place (see Eli’s HCW, Vol. XXVI, No. 30). Even the notorious fraudster Dr. Jacques Roy received only a 35-year sentence for a much larger fraud scheme.

“How you get anything close to 75 years is beyond me and makes no sense at all,” Patrick Cotter, a former federal prosecutor who heads the government interaction and white-collar practice group at Greensfelder, Hemker & Gale in Chicago, told ALM Media. “In 35 years, I have never heard of the government’s [prison term] recommendation being doubled by the judge, particularly when the government is asking for a tough sentence anyway.”

Gejaa Gobena, a litigation partner at Hogan Lovells and former chief of the DOJ Criminal Division’s Health Care Fraud Unit, told ALM the same. “We prosecuted hundreds of cases and never had a sentence approaching anywhere near this,” Gobena said.

Fifty-three-year-old Neba, the mother of 7- year-old twin sons, was diagnosed in May with stage IV metastatic breast cancer and has filed an appeal of the conviction and the sentence, ALM reports.