Home Health & Hospice Week

Feds rack up convictions for wheelchair funny business.

Recent jury convictions underscore the fact that durable medical equipment companies remain under scrutiny by U.S. law enforcement officials--and that unscrupulous providers are at risk of substantial prison sentences.

Among the latest felons is Dr. Anant Mauskar, the Houston-area doctor whose crimes sparked the federal crackdown on wheelchair fraud known as Operation Wheeler Dealer.

A federal jury in Texas last month found Mauskar guilty of 20 counts of fraud and one count of conspiracy. Between 2001 and 2003, he submitted claims for motorized wheelchairs for beneficiaries who were unlawfully referred to him and who did not qualify for the equipment under Medicare guidelines, says U.S. Attorney Chuck Rosenberg.

Several beneficiaries testified that Mauskar did not examine them before prescribing wheelchairs. Mauskar billed Medicare more than $4 million for the fraudulent services, receiving $1.4 million.

The verdicts mark the end of Mauskar's second trial for the same charges. The first trial began in February 2005 and ended in a mistrial on April 1, after the jury was unable to reach a unanimous verdict. The second jury deliberated for a day and a half before delivering the convictions.

With sentencing scheduled for February, Mauskar remains free on bond. The conspiracy conviction carries a maximum punishment of five years imprisonment and a $250,000 fine. Each of the health care fraud convictions carries a maximum sentence of 10 years in prison and a $250,000 fine.

Georgia Scenario Employs Similar Model

On Nov. 9, a U.S. District Court judge in Georgia sentenced three Atlanta-area residents to prison terms for their role in a hustle that bilked the federal government out of about $1 million, the Atlanta Business Chronicle reports.

Ukeme Etuk and Edem Etuk, owners of Fairburn, GA-based Durable Medical Supplies Inc., paid what they called "referral fees"--but what prosecutors deemed kickbacks--to Melody Holmes, a physician's employee, to provide more than 60 signed fraudulent certificates of medical necessity for wheelchairs and other DME items.

The judge sentenced Edem Etuk to one year and Ukeme Etuk to two years in federal prison and gave both three years of supervised release, according to the paper. The couple also forfeited a bank account containing proceeds of the crime as well as other property, and they must re-pay the remaining amount they illegally obtained.

Because Holmes cooperated with investigators, prosecutors asked for a reduced sentence, which the court granted. The judge sentenced Holmes to serve a year in federal prison followed by three years of supervised release and ordered her to pay $665,000 in restitution to Medicare and Medicaid.

Dallas Racket 'Particularly Egregious,' OIG Says

Meanwhile, a jury in Dallas on Nov. 16 convicted Ignatius Chuka "Chuck" Ogba, owner of a DME company called Universal Health Services Inc., along with Ogba's younger brother Ifeanyi "Iffy" Boniface Ogba and Dr. Patrick Antoon for their role in an illegal DME scheme.

"The types of kickbacks and obstruction of justice that occurred in this case are particularly egregious examples of how the Medicare Trust Fund is being exploited by dishonest individuals," said Health & Human Services Inspector General Daniel Levinson.

Chuck Ogba hired recruiters to find Medicare beneficiaries to receive scooters or power wheelchairs, and he, his brother and other Universal employees paid Antoon $200 to sign certificates of medical necessity. Universal would then provide less expensive equipment than it billed Medicare for, or sometimes no equipment at all. Under the illegal arrangement, Universal billed Medicare in excess of $12 million.

The jury found the defendants guilty of conspiracy to commit health care fraud, paying and receiving illegal kickbacks, and money laundering. It also convicted them of paying and receiving kickbacks and health care fraud. In addition, the jury convicted the Ogbas of engaging in illegal monetary transactions, and Antoon of obstructing a criminal health care investigation, altering and falsifying health care records, and obstructing a federal grand jury investigation.

Beware: "The Office of Inspector General will continue to vigorously investigate and ensure the prosecution of health care providers and suppliers ... who defraud the Medicare program and its vulnerable beneficiaries," Levinson warned.