A dozen Fort Bend County residents are among more than 30 accused of multimillion-dollar medicare fraud according to federal indictments unsealed today.
The result of an investigation by a joint federal-state Medicare Fraud Strike Force, the indictments accuse a total of 32 people of various frauds against the government medical program amounting to more than $16 million.
Most of those named in the indictments are accused of schemes involving fraudulently extracted Medicare payments for power wheelchairs, “arthritis kits,” and internal feeding supplies, the DOJ said in a statement.
A DOJ spokeswoman said that as of noon, all or nearly all of those named in the indictments had been arrested, most in the Houston area but some in New York and New Orleans.
“Our Medicare Strike Force is striking back against health care fraud in all its forms and wherever it occurs. We will stop fraud as its happening, using real-time data analysis of Medicare billing records,” said Texas Deputy Attorney General David Ogden. “Those who commit health care fraud will not be allowed to steal money from American taxpayers.”
The schemes involved medical-related businesses in Sugar Land, Richmond, Humble and Houston.
According to unsealed indictments, Fort Bend County residents accused and arrested in the fraud investigation, and the business entities in which they were involved, include:
Onward Group Healthcare Inc. at 106 Bayview Drive, Suite A, Sugar Land. The company provided power wheelchairs and other medical equipment to Medicare beneficiaries.
→ Doris Ngozi Vinitski, 45, identified as owner and operator of Onward Group, who maintained a Medicare group provider number for the company “in order to submit Medicare claims for durable medical equipment that was midically unnecessary and not provided.”
→ Howard Grant, 59, a physician “who signed prescriptions ordering medically unnecessary DME (durable medical equipment) that served as the basis of certain of Onward’s claims to Medicare.”
→ Michael Kalu Obasi, 34, “who referred beneficiaries to Onward so that claims for medically unnecessary DME could be filed with Medicare.”
→ Yolanda Stella Delrio, 59, “who assisted in the day-to-day operations of Onward, including the submission of claims for medically unnecessary DME to Medicare.”
→ Ju-Ying Qian, 60, “who referred beneficiaries to Onward so that claims for medically unnecessary DME could be filed with Medicare.”
→ Oliver Nkuku, who is accused of delivering “medically unnecessary DME to Medicare beneficiaries for Onward, including power wheelchairs and orthotics.”
According to one of the indictments, Vinitski and other defendants submitted more than $2.2 million in fraudulent Medicare claims.
KO Medical Inc., of 301 S. 9th St., Suite 108, Richmond. According to the indictments, the company provided power wheelchairs and other medical equipment to Medicare beneficiaries.
→ Oliver Nkuku, 44, an owner and operator of KO Medical accused of submitting about $931,000 in false Medicare claims for power wheelchairs, wheelchair accessories and motorized scooters. Separately, he also was indicted for allegedly conspiring to submit about $2.2 million in false Medicare claims between October 2003 and March 2009.
→ Kate Nkuku, 45, also identified as a KO Medical owner/operator, and also accused of submitting $931,000 of false Medicare claims. One indictment accuses her of improperly using “various billing code modifiers in connection with KO’s submission of claims that allowed her to conceal the fact that KO was providing DME without a proper prescription from a licensed physician…”
→ Obisike Okereke, 35, who “delivered medically unnecessary DME for KO.”
Sefan health Care Services Inc., at 9894 Bissonnet, Suite 770, in Houston. The company provided “othotics and other DME to Medicare beneficiaries,” according to one of the indictments unsealed Wednesday.
→ – Kate Ose Olear, 42, identified in an indictment as Sefan’s owner, director and manager, is accused of submitting about $2.75 million in false claims to Medicare on behalf of beneficiaries that included “several who were deceased on the alleged day of service.”
Luant & Odera Inc., operating under the assumed name Tonni Medical Equipment and Supplies, “purportedly doing business at 9720 Beechnut Street, Suite 125 in Houston, and at other addresses in Houston and Spring, according to one indictment.
→ Ezechukwu J. Ohaka, 40, identified as one of the company’s owners, is accused of submitting about $3.9 million in false Medicare claims between March 2007 and March 2009, including claims “for power wheelchairs and wheelchair accessories for beneficiaries who did not need them.” One of the indictments unsealed Wednesday says Ohaka also “paid kickbacks to co-conspirators as payment for Medicare beneficiary billing information.”
→ Helen Ehi Etinfoh, 49, also identified as a Luant owner/operator, is also accused in the filing of the $3.9 million in fraudulent claims, and of paying kickbacks.
Family Healthcare Group Inc. (Family Healthcare), “purportedly doing business” at 8313 Southwest Freeway, Suite 109, Houston. The company, according to an indictment, “purported to provide orthotics and other DME to Medicare beneficiaries.”
→ Mary Ellis, 53, a licensed vocational nurse, is accused of conspiring to submit more than $1.1 million in false Medicare claims from October 2007 to March 2009 for equipment including “arthritis kits.” She “allegedly referred beneficiaries to Family Healthcare so that claims could be filed with Medicare the beneficiaries did not need, use, or in some instances, even receive,” an indictment states. It also alleges the woman received a “kickback by the owners of Family Healthcare for each Medicare benficiary she referred.”
The cases are being prosecuted by attorneys from the U.S. Attorney’s Office.
“Americans deserve quality healthcare and have the right to expect that money expended on Medicare is not wasted,” said U.S. Attorney Tim Johnson. “We will prosecute anyone who fraudulently obtains Medicare benefits at the expense of the truly needy.”
The DOJ-Health & Human Services Medicare Strike Force is a multi-agency team of federal, state and local investigators “designed to combat Medicare fraud through the muse of Medicare data analysis techniques and an increased focus on community policing,” according to information from the Justice Department.
Joe- You may be able to fool some people about Canada’s healthcare system, but I’m not one of them, sorry.
Also, I am sure that our toll road system is looking to buy that bridge over the Brazos, and once again, we will all continue to be robbed of our resources due to our ignorance privatization and government.
Megabite, I have empirical knowledge of Canada’s single payer system and you are truly and tragically misinformed at best.
If you think Canada’s healthcare is better than ours there’s a bridge over the Brazos I’d like to sell ya. It sucks.
I believe in a single payer system myself. Every single person pays for their own instead of paying for some welfare Mom’s 5 kids while she sits home all day and watches Maury.
A “single payer system” would not involve “insurance companies.” For the sake of profits, insurance companies work hard to say NO to claims in many varied ways. They do not support the health of their clients, and of course, not having bogus insurance doesn’t help either.
In choosing who is to allow my doctor to provide medical care to me, I will choose the accountability of my government long before that of a for profit health care insuror that is first and foremost motivated by his bottom line. All other developed countries except the USA and China have universal health care.
My cousin, who lives in South Carolina, broke his foot in several places showing two protruding bones. He immediately grabbed the phone and called the airlines to book the first plane to Canada. The flight too 98% of the “waiting time” for him to be cared for in Canada, where he has a dual citizenship. They took him from the airport and the surgery took four hours. The surgery was excellent and free. He is almost back to normal and debt free. He said it was very freighting to be injured in Barbaria.
Here is the sad part. The medical equipment industry represents less than .5% of healthcare, but is currently receiving by far the most cutbacks of any sector.
I am very happy that these bad actors are being put away. It is the handful of bad apples that have casued caring reputable dealers to suffer greatly.
This task force has reputedly saved taxpayors over 674 Million tax dollars. This money should be used to require medicare to give more scrutiny to whom it issues medicare numbers. In addition they should have a Medicare rep for each area. These reps could visit each site 2x per year. They could do chart audits and make sure all of the rules are being complied with. Had this type system been in place, these disreputable companies would have never had the chance to steal.
Pat B
Yes, I support a single payer health plan able tobe serve by private insurances. An that will prohibit these private Insurance from running away, from its customers, like a cat.
Joe,
Medicare is not a “single payer” system per se. It is administered by “fiscal intermediaries” who are, in fact, large insurance companies such as Cigna, Aetna and BCBS who are contracted by the federal government.
In each one of these allegations the question of delivery is brought up. What I would like to know for my own personal curiosity is whether or not these entities were accredited? I cannot imagine them being so nor even attempting to achieve such status. A site survey would have / should have uncovered any wrong doing. If they were, the accrediting body needs to be dragged into this as well.
All that said there are bad actors in the system. They need to be ferreted out and prosecuted.
Simile correction: The insurance company did not “run like a John Deer” It ran AWAY, like a cat with it’s tail on fire. It is no wonder that so many people “choose” no insurance over the “security” that the insurance industry offers. We need a real health care system. We need single payer!
The details of this “Bust” seems to be a desperate attempt to direct people’s attention to the pitfalls of “government run health care systems.” Not only am I not deceived by this attempt at redirection and deception, I am 100% in favor of a single payer health care system like every other first and most second world countries have. It is a tragedy that Americans can be so gullible to corporate interests that they would speak against their own self interests.
I have had the best insurance that money can buy, for decades, but my insurance company ran like a deer when a cancer diagnosis came up. In addition, it was a rush to get back to work after surgery, least the insurance be lost completely. What an insurance scam!!
Please don’t tell me we all need “insurance.” Insurance I’ve got, thank you. What we all need is a single payer system that we can all rely on, like every other civilized country.